晚期卵巢上皮癌二次细胞减灭术的临床探讨  

EFFECTS OF SECONDARY CYTOREDUCTIVE SURGERY ON THE SURVIVAL OF PATIENTS WITH ADVANCED EPITHELIAL OVARIAN CANCER

作　　者：臧荣余[1] 张志毅[1] 蔡树模[1] 

机构地区：[1]复旦大学医学院附属肿瘤医院,上海200032

出　　处：《肿瘤》2001年第3期197-200,共4页Tumor

基　　金：第三届海峡两岸肿瘤学术研讨会大会宣读 (1999 10 ;上海 )

摘　　要：目的　探讨再次肿瘤细胞减灭术的作用及影响该手术的危险因素。方法　回顾性分析晚期卵巢上皮性癌行再次手术 10 6例 ,对各种手术类型的价值分层分析。分别采用Cox逐步回归和Logistic回归分析预后因素和影响再手术的危险因素。结果　中位年龄 5 0岁 ,Ⅲ期为 10 1例 ,Ⅳ期为7例。总的切净率 43 4% (残癌≤ 1cm) ,切净组和未切净组的中位生存期 2 0月和 8月 (P =0 0 0 0 0 ) ,复发癌和中间性肿瘤细胞减灭术 ,切净组的生存明显延长。多因素分析除残癌大小外 ,缓解期 (P =0 0 0 78)和难治性腹水 (P =0 0 0 0 1)也是预后的影响因素。并且难治性腹水是影响再次肿瘤细胞减灭术的危险因素 (P =0 0 0 2 3)。结论　二次肿瘤细胞减灭术对复发癌和中间性肿瘤细胞减术有肯定的疗效。但出现难治性腹水者不宜再手术。Objective To clarify the clinical role and affecting factors or secondary cytoreductive surgery (SCR) in patients with advanced epithelial ovarian cancer (AEOC). Methods One hundred and six women with AEOC treated with SCR were retrospectively reviewed. Survival curves were computed using the Kaplan Meier method with differences in survival estimated by log rank test. Independent prognostic factors for secondary attempts evaluated by Cox stepwire regession. Results Residual disease after SCR, as well as refractory ascites ( P =0 0001) and progression free interval ( P =0 0078) are independent factors of survival in patients with AEOC, especially in those with recurrence ( P =0 0000) and interval cytoreduction ( P =0 0001). And only refractory ascites (χ 2=9 2781, P =0 0023) is the factor that affecting secondary aggressive debulking surgery.Conclusion Secondary cytoreductive surgery is effective in the treatment of advanced epithelial ovarian carcinoma. Second line chemotherapy has no influence on the secondary surgery and survival.$$$$

关 键 词：二次细胞减灭术 卵巢肿瘤 晚期 卵巢上皮癌 药物疗法 预后 

分 类 号：R737.31[医药卫生—肿瘤]