2014年，世界卫生组织推出了一种新的组织学分类方法，将原发性粘液性卵巢癌分为两种亚型：扩张型（ES）或浸润型亚型（IS）。本研究探讨了这些组织学亚型在生存结局上的临床意义。分析了2003年至2021年之间接受原发手术的131例PMOC患者的数据。收集了患者的基线特征、手术和病理信息。计算了生存结局，并研究了影响其生存结局的因素。在中位随访时间为55.9个月期间，27例（20.6%）患者发生了复发，20例（15.3%）患者死亡。在131例患者中，经过滑片复审，有113例患者被分为87例（77%）ES型和26例（23%）IS型。IS型在晚期、淋巴结受累和术后残留肿瘤方面更常见，预后较差。多元分析表明，晚期和术后残留肿瘤与较差的生存相关，而IS型未显示出统计学意义。对于I期疾病的亚组分析显示，亚型间的生存率无明显差异。然而，IS组中接受保育生育手术的患者显示了83.3%的5年无进展生存率，显著低于未进行生育保育的患者，无论组织学亚型如何（ES亚型的5年无进展生存率为97.9%，P = 0.002；IS亚型的5年无进展生存率为100%，P = 0.001）。PMOC的IS亚型具有较差的生存结局和更高比例的晚期肿瘤。尽管其独立预后意义仍不确定，但应考虑给IS组中进行生育保育的患者进行辅助化疗。版权所有 © 2023，Elsevier Inc.发表。

In 2014, the World Health Organization introduced a new histologic classification by dividing primary mucinous ovarian carcinoma (PMOC) into two: expansile (ES) or infiltrative subtypes (IS). This study investigated the clinical implications of these histological subtypes on survival outcomes.Data from 131 patients with PMOC who underwent primary surgery between 2003 and 2021 were analyzed. The patients baseline characteristics, surgical and pathological information were collected. Survival outcomes were calculated, while factors affecting them were also investigated.During 55.9 months of median follow-up, 27 (20.6%) patients experienced recurrence and 20 (15.3%) died. Among 131 patients, 113 patients were classified into 87 (77%) ES and 26 (23%) IS after a slide review. Advanced stage, lymph node involvement, and residual tumors after surgery were more common in the IS, showing poorer prognosis. In multivariate analyses, advanced stage and residual tumors after surgery were associated with worse survival, while the IS showed no statistical significance. In subgroup analysis for stage I disease, survival did not vary between subtypes. Nevertheless, patients in the IS group who underwent fertility-sparing surgeries demonstrated a 5-year progression-free survival (PFS) rate of 83.3%, significantly lower than patients without fertility preservation, irrespective of histologic subtypes (5-year PFS rate: 97.9%; P = 0.002 for the ES, 5-year PFS rate: 100%; P = 0.001 for the IS).The IS of PMOC had poorer survival outcomes and a higher proportion of advanced-stage tumors. Although its independent prognostic significance remains uncertain, adjuvant chemotherapy should be considered for patients with fertility preservation in the IS group.Copyright © 2023. Published by Elsevier Inc.