卵巢上皮性癌155例的治疗与预后  

Treatment and Prognostic Factors of Epithelial Ovarian Cancer

作　　者：魏丽惠[1] 钱和年[1] 李蔚范[1] 赵彦[1] 吴燕[1] 张安聚[1] 虞幸[1] 

机构地区：[1]北京医科大学人民医院妇科肿瘤中心

出　　处：《中华妇产科杂志》1997年第8期476-479,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：探讨卵巢上皮性癌的治疗与影响预后的因素。方法：对１９７０年１月至１９９２年１２月在我院治疗的１５５例卵巢上皮性癌进行回顾性分析。全部手术切除标本经病理检查诊断并按ＦＩＧＯ分期标准进行分期，４２例行２次手术，４例行３次手术。除６例外，余１４９例均于手术后行化疗，３２例于第２次术后再次行化疗，９例因复发再次化疗。结果：２年、５年、１０年的生存率分别为Ⅰ期９２．４％、８７．０％、７０．６％；Ⅱ期９１．９％、６３．６％、４７．８％；Ⅲ期５９．９％、３８．２％、１９．２％；Ⅳ期２５．０％、２５．０％、０．０％（Ｐ＜０．００１）。６例未化疗者均在术后２年内死亡。结果表明，预后与临床分期、细胞分化、残留癌灶大小有关。５年生存率中，Ⅰ期为８７．０％和Ⅲ期为３８．２％（Ｐ＜０．００１）；Ｇ１的５年生存率为９５．９％，Ｇ３为１１．８％（Ｐ＜０．００１）；无残留癌灶者为９７．６％，残留癌灶＞２ｃｍ者为２１．２％（Ｐ＜０．００１）。结论：在卵巢上皮性癌初次手术时残留癌灶＜２ｃｍ，并于术后尽早开始化疗，可提高生存率。Objective: To study the treatment results and prognostic factors of epithelial ovarian carcinoma. Methods: Retrospective study of 155 cases of ovarian epithelial carcinoma admitted in our hospital since Jan. 1970 to Dec. 1992. All of these cases had postoperative pathological diagnosis and staging according to FIGO. 42 cases had second operations and 4 cases had the third. 149 cases had postoperative chemotherapies except for 6. Chemotherapies were also given to 32 cases after the second operation, while 9 for recurrence. Resutls: The 2 year, 5 year, 10 year survival rates of stage Ⅰ were 92.4%, 87.0%, 70.6%; and Ⅱ 91.9%, 63.6%, 47.8%; Ⅲ 59.9%, 38.2%, 19.2% ad Ⅳ 25.0%, 25.0%, 0.0% respectively. All 6 cases without chemotherapy after surgery died within 2 years. The results indicated that the prognosis of ovarian epithelial carcinoma was related to clinical stage, cellular grade and tumor residues. The 5 year survival rates for stage Ⅰ was 87.0% and Ⅲ 38.2% ( P <0.001); and cell G 1 95.0% and G 3 11.8% ( P <0.001),while no residual tumor 97.6% and with residual tumor >2cm 21.2% ( P <0.001) respectively. Conclusion: Residual tumor of ovarian epithelial carcinoma <2cm after primary surgery and chemotherapy right after surgery can improve survival rates.

关 键 词：卵巢肿瘤 预后 治疗 上皮性癌 

分 类 号：R737.31[医药卫生—肿瘤]