上皮性卵巢癌的综合治疗及疗效分析  

Combination treatment and its efficacy on epithelial ovarian carcinoma

作　　者：孙廷慰[1] 酆豫增[1] 祝亚平[1] 李双弟[1] 

机构地区：[1]上海市第一人民医院妇产科,200080

出　　处：《上海医学》2001年第8期487-489,共3页Shanghai Medical Journal

摘　　要：目的　探讨不同期别上皮性卵巢癌的治疗方法选择及其疗效。方法　对 1989年 1月～ 1997年 8月 ,我院收治的 182例上皮性卵巢癌患者进行回顾性分析 ,全部病例均在本院手术 ,确定病理类型、分化程度 ,并按FIGO标准进行分期。其中 15 8例先行手术治疗 ,术后予以化疗 ;在Ⅲ、Ⅳ期中有 2 4例在先期化疗后手术 ,术后亦行化疗。此外 ,对 38例进行了第 2次肿瘤细胞减灭术 (减灭术 ) ,其中 4例再施第 3次减灭术。结果　 1.全组 2年、5年生存率分别为 :Ⅰ期 96 .92 %、94.95 % ;Ⅱ期 10 0 %、94.12 % ;Ⅲ期 5 4.44 %、34 .98% ;Ⅳ期 11.1%、0 % (P <0 .0 0 1)。 2 .在Ⅱ～Ⅳ期的 5年生存率中 ,术后无残留灶者为 85 .7% ;残留灶 <2cm者为 5 2 .14% ;残留灶 >2cm者为 9.6 1% (P <0 .0 0 1)。3.在Ⅲ、Ⅳ期中先手术与先期化疗的手术切净率分别为 2 4.0 0 %和 6 6 .6 7%(P <0 .0 0 1)。其 2年、5年生存率为 41.10 %、2 1.6 2 %对 6 6 .6 7%、45 .13% (P =0 .0 15 )。 4.有 45例在 6 0处复发 ,复发率 2 4.7%。Ⅲ、Ⅳ期的复发率明显超过Ⅰ、Ⅱ期 ,在先手术及先化疗组差异无显著性。结果提示 :生存率与临床期别、残留灶大小有关 ,而Ⅲ、Ⅳ期中采用先期化疗能显著提高手术切净率 ,亦能提高生存率 ,但不能降低复发率。Objective To investigate different therapeutic regimens and their efficacy on epithelial ovarian carcinoma of different stages. Methods Retrospective analysis was made in 182 epithelial ovarian carcinoma cases treated from January 1989 to August 1997, all of them were operated on in our institute; Pathological classification and grading were made according to FIGO criteria. Among 182 cases, operation followed by postoperative chemotherapy was carried out in 158 patients, while in 24 cases of stage Ⅲ and Ⅳ, chemotherapy surgery chemotherapy regimen was adopted. Thirty eight patients underwent secondary cytoreductive operation, while tertiary cytoreduction was carried out in 4 of them. Results 1.The 2 year and 5 year survival rates were 96.92% and 94.95% in stage Ⅰ; 94.12% and 100% in stageⅡ; 54.44% and 34.89% in stage Ⅲ,and 11.1% and 0 in stage Ⅳ( P <0.001). 2.The 5 year survival rate of stageⅡ Ⅳin those without microscopic residual focus was 85.7%, while the rates were 52.14% and 9.16% in those with residual <2cm and >2cm respectively. 3. The optimal cytoreduction rate in stage Ⅲ and Ⅳwas 24.00% in surgery chemotherapy regiman group(“surgery first”), while it was 66.67%( P <0.001) in chemotherapy-surgery-chemotherapy regimen group (“chemotherapy first”). The 2 year and 5 year survival rates of those two regimens were 41.10%,21.60%,vs 66.67% ,45.13% ( P =0.015). 4. Recurrence was found in 45 cases (24.7%) at foci 60. The recurrence rate was obviously higher in stage Ⅲ and Ⅳ than that in stage ⅠandⅡ, while the difference was not signficant between “surgery first”and“chemotherapy first” group. Results suggested that the survival rate was related to clinical stages and the size of residual focus; in stage Ⅲ and Ⅳ, optimal cytoreduction rate was significantly higher in cheomtherapy surgery chemotherapy regimen, but recurrence rate was not reduced. Conclusion The therapeutic efficacy may be improved with early diagnosis, correct staging with co

关 键 词：上皮性卵巢癌 综合治疗 疗效 

分 类 号：R737.31[医药卫生—肿瘤]