胃源性转移性卵巢癌的治疗和预后(附49例分析)  

Treatment and Prognosis of Metastatic Ovarian Cancer Originated from Gastric Carcinoma: 49 Cases Report

作　　者：夏蛮[1] 左朝晖[2] 蔡净亭[1] 周琨妍 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院/湖南省肿瘤医院妇瘤科,长沙410013 [2]中南大学湘雅医学院附属肿瘤医院/湖南省肿瘤医院胃十二指肠胰腺外科,长沙410013

出　　处：《中国现代手术学杂志》2016年第1期51-54,共4页Chinese Journal of Modern Operative Surgery

基　　金：国家自然科学基金青年基金(81500150);湖南省卫生计生委科研项目(B2014-116)

摘　　要：目的探讨胃源性转移性卵巢癌的临床特点、诊断、治疗方法与预后因素。方法回顾性分析2004年1月～2014年1月湖南省肿瘤医院收治的49例胃源性转移性卵巢癌患者的临床资料。结果 49例患者平均年龄39.9（24～54）岁。绝经前期患者占85.7%,转移灶位于双侧卵巢者38例（77.6%）,单侧者11例（其中左侧2例,右侧9例）。同时性转移者29例,异时性转移者20例。全组患者的中位生存时间为16.4月,1、2、3、5年生存率分别是61%,31%,16%,8%。单因素分析显示,与预后相关的因素分别是转移灶范围（P〈0.05）、残留灶大小（P〈0.05）和术后化疗（P〈0.05）,而年龄、月经史与预后无明显相关性。多因素COX回归分析示术后残留灶大小和术后化疗是胃源性转移性卵巢癌患者的独立影响因素。结论胃源性转移性卵巢癌恶性程度高,预后差,根治性手术和化疗可以延长患者的生存期。Objective To investigate the clinical feature,diagnosis,treatment and prognosis of metastatic ovarian cancer originated from gastric carcinoma. Method Clinical and pathological data of 49 patients with metastatic ovarian cancer originated from gastric carcinoma from January 2004 to January2014 in Hunan provincial tumor hospital were analyzed retrospectively. Results All 49 patients aged from 24 to 54 years with an average of 39. 9 years. 85. 7 percent of these patients were in the premenopausal state. The metastasis ovarian cancer was located in bilateral ovaries in 38 cases（ 77. 6 %）,and in unilateral ovaries in 11 cases（ 2 cases at left side,9 cases at right side）. 29 patients presented with synchronous metastasis,while 20 cases developed metachronous ovarian metastases during follow-up. The median overall survival time of 49 patients was 16. 4 months. The survival rate of 1,2,3 and 5 years were61 %,31 %,16 % and 8 % respectively. The extent of metastasis,the size of the postoperative residual lesion and the chemotherapy were correlated with prognosis of metastatic ovarian cancer by univariate analysis. While Cox regression analysis showed the size of residual lesion and postoperative chemotherapy were the independent factors affecting prognosis. Conclusions Patients with metastatic ovarian cancer originated from gastric carcinoma have very poor prognosis. Radical surgery combined with chemotherapy will prolong the survival duration of those cases.

关 键 词：卵巢肿瘤 肿瘤转移 胃肿瘤 预后 因素分析 统计学 

分 类 号：R737.31[医药卫生—肿瘤]