Ⅲ期浆液性卵巢癌存活及复发相关因素分析  

Prognostic and recurrent factors in patients with serous ovarian cancer of FIGO stage Ⅲ

作　　者：成夜霞[1] 冯捷[1] 刘晨[1] 白符[1] 杨蓉[1] 

机构地区：[1]北京大学人民医院妇科肿瘤中心,100044

出　　处：《中国妇产科临床杂志》2004年第4期281-285,共5页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的　探讨影响Ⅲ期浆液性卵巢癌存活及复发的相关因素。方法　回顾性分析 1 982年 1月～2 0 0 2年 6月在我院住院治疗的Ⅲ期浆液性卵巢癌患者的临床资料 ,比较年龄、不同FIGO亚期、病理分级、肿瘤细胞减灭术后残留肿瘤大小、盆腔及腹主动脉旁淋巴结状况及不同化疗情况的缓解率、缓解后的复发率及 3年、5年存活率。结果　 5 8例患者中 ,完全缓解 34例 ,部分缓解 8例 ,未缓解 1 6例。化疗≥ 6疗程者完全缓解率74 % ,<6疗程者无 1例完全缓解 ,二者之间差异有极显著性 (P <0 0 1 ) ;残留肿瘤直径 <2cm者 ,完全缓解率 80 % ,残留肿瘤直径≥ 2cm者 ,完全缓解率 4 7% ,二者之间差异有显著性 (P <0 0 5 ) ;盆腔及腹主动脉旁淋巴结无转移者完全缓解率 93% ,有转移加未切除者完全缓解率 4 7% ,二者之间差异有显著性 (P <0 0 1 )。多因素Logistic回归分析显示 :化疗和淋巴结状况是决定能否完全缓解的重要因素 ;影响 3年生存率及 5年生存率的主要因素首先是化疗 ,其次为淋巴结是否切除及是否转移。去掉淋巴结因素后Logistic回归分析显示 ,化疗是决定能否完全缓解的重要因素 ,影响 3年生存率的主要因素是化疗 ,影响 5年生存率的主要因素首先是化疗 ,其次为残留肿瘤大小。 34例完全缓解病例中 ,1 8例 (5 2 94 % )Objective To assess the related factors of prognosis and recurrence after treatments in patients with serous ovarian carcinoma of FIGO stage Ⅲ.Methods The clinic records of the 58 women with ovarian cancer of stage Ⅲ,admitted to Peking University People's Hospital from January 1982 to June 2002,were retrospectively analyzed on age,FIGO substages,histological grades,size of residual disease after primary cytoreductive surgery,resection and metastasis of pelvic and periaortic lymph node,as well as the numbers of postoperative chemotherapy cycles,the complete response rate,the recurrence rate,the 3- and 5-year survival rates.Chi-square test,Logistic regression analysis,Kaplan-Meier survival curve and Log-rank test were used for statistic analysis.Results In all 58 patients underwent primary cytoreductive surgery,34 were complete response(CR),8 partial response and 16 non response.In univariate analysis,The CR rate of patient recieved ≥ 6 chemotherapy cycles after surgery or without pelvic or periaortic lymph node metastasis was higher than that <6 cycles(74% versus 0%, P< 0.01)or with lymph node metastasis and with positive lymph node un resectable(93% verse 47%, P< 0 01).The CR rate of patients with<2 cm residual disease was higher than that ≥ 2 cm residual disease(80% versus 47%, P< 0 05).Multivariate analysis showed chemotherapy cycle number and pelvic or periaortic lymph node status were important factors for CR;The factors affecting 3- and 5-year survival rate were chemotherapy cycle number and lymph node status.Without regard to lymph node status,chemotherapy cycle number was important for CR;the 3-year survival rate was closely related to chemotherapy cycle number and the 5-year survival rate was related to both chemotherapy cycle number and residual disease.After surgeryand chemotherapy,18 out of 34 CR patients presented cancer recurrence.Univariate analysis showed that the recurrent risk of disease of FIGO Ⅲc or residual disease ≥2 was higher than that Ⅲa and Ⅲb or residual diseas

关 键 词：完全缓解 化疗 复发 肿瘤大小 卵巢癌 淋巴结 浆液性 生存率 FIGO 患者 

分 类 号：R737.31[医药卫生—肿瘤]