二次肿瘤细胞减灭术在铂类敏感的复发性卵巢上皮癌中的作用  

Role of Secondary Cytoreductive Surgery for Patients with Platinum Sensitive Recurrent Epithelial Ovarian Cancer

作　　者：曾赛田[1] 郭亮[1] 刘世凯[1] 王东晖[1] 奚杰[1] 高洁凡[1] 冯静[1] 张亮[1] 

机构地区：[1]河北医科大学沧州临床医学院妇科,河北沧州061001

出　　处：《现代生物医学进展》2014年第26期5109-5111,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨二次肿瘤细胞减灭术对铂类敏感的复发性卵巢上皮癌治疗的临床意义。方法:回顾性分析我院于2002年1月至2012年12月收治的115例铂类敏感的复发性卵巢上皮癌患者的临床及随访资料。结果:在115例铂类敏感的复发性卵巢上皮癌中,66例接受了二次肿瘤细胞减灭术(手术组),术后辅以铂类为基础的化疗。49例患者只接受了以铂类为基础的化疗(对照组)。两组患者肿瘤病理分型无统计学差异(P=0.485)。与对照组相比,手术组FIGO分期IV期患者的比例少(15.2%VS 34.7%,P=0.014),低分化患者的比例少(71.2%VS 91.8%,P=0.024),多发复发病灶患者的比例少(28.3%VS 49.0%,P=0.027)。平均随访30.2个月(6-48个月),Kaplan-Meier生存分析显示,手术组与对照组患者的中位生存期分别为35.0个月和27.0个月,差异有统计学差异(Log rank 7.9,P=0.005)。多因素Cox回归分析显示,校正了年龄、肿瘤病理类型、病理分级及FIGO分期后,不同治疗方案是复发上皮性卵巢癌患者远期生存率的独立影响因素。结论:二次肿瘤细胞减灭术可以改善铂类敏感的复发性卵巢上皮癌患者的临床预后。Objective： To investigate the clinical benefit of secondary cytoreductive surgery for patients with platinum sensitive recurrent epithelial ovarian cancer. Methods： The clinical and follow-up data of 115 patients with recurrent epithelial ovarian cancer treated in our department between January 2002 and December 2012 were retrospectively analyzed. Results： 66 patients underwent secondary cytoreductive surgery assist6d by platinum based chemotherapy （operation group）, and other 49 patients were treated with chemotherapy only（control group）.Patient＇s tumor pathological types of two groups were of no statistical difference（P=0.485）. Compared with the control group, FIGO clinical stage IV Patients were fewer in operation group （15.2% VS 34.7%,P=0.014）, poorly differentiated carcinoma patients were fewer in operation group（71.2% VS 91.8%,P=0.024）, multiple recurrent lesions patients were fewer in operation group （28.3% VS 49.0% ,P=0.0270）. All patients were followed up for the average follow-up of 30.2 months （range 6-48 months）. Kaplan-Meier survival analysis showed that the median survival time was significantly different between the two groups （35 months VS 27 months, Log rank 7.9, P=0.005）. Cox regression multivariate analysis showed that with adjustment for age, pathological type, pathological grading and FIGO clinical staging, different treatments were the independent predictors of recurrent epithelial ovarian carcinoma patients with long-term survival rate. Conclusion： The secondary cytoreductive surgery may improve the prognosis of patients with recurrent, platinum-sensitive epithelial ovarian carcinoma.

关 键 词：肿瘤细胞减灭术 卵巢癌 复发 生存期 

分 类 号：R737.31[医药卫生—肿瘤]