二次肿瘤细胞减灭术联合化疗治疗复发性卵巢癌的预后与影响因素分析  

Analysis of prognosis and influencing factors of secondary cytoreductive surgery combined with chemotherapy for recurrent ovarian cancer

作　　者：彭光彩 周锦红 曾淑梅 孙彦飞 王夙斐 Peng Guangcai;Zhou Jinhong;Zeng Shumei;Sun Yanfei;Wang Sufei(Department of Obstetrics and Gynecology,Affiliated Zhejiang Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Yangtze University,Jingzhou 434300,China)

机构地区：[1]浙江大学医学院附属浙江医院妇科,杭州310000 [2]长江大学附属第一医院妇科,荆州434000

出　　处：《中华内分泌外科杂志》2021年第3期243-247,共5页Chinese Journal of Endocrine Surgery

基　　金：湖北省卫生健康委员会科研项目(WJ2019M085)。

摘　　要：目的探讨二次肿瘤细胞减灭术(SCS)联合化疗治疗复发性卵巢癌的预后与影响因素。方法回顾性分析长江大学附属第一医院2012年6月至2015年6月收治的复发性卵巢癌患者102例临床资料,根据治疗方法分组,将采用紫杉醇/卡铂(paclitaxel/carboplatin,TC)化疗的31例患者纳入对照组,采用SCS联合TC化疗的71例患者纳入观察组,比较两组治疗后临床疗效及5年生存结局,并分析观察组预后影响因素。结果观察组临床疗效总有效率、1年生存率、3年生存率、5年生存率明显高于对照组,观察组中位生存时间为52个月,明显长于对照组17个月(P<0.05);死亡组与生存组患者年龄、病理类型、组织分化、复发肿瘤大小、复发肿瘤位置比较差异无统计学意义,死亡组首次FIGO分期Ⅳ期、复发肿瘤数量3个以上、有腹水、SCS术后病灶残留大小>1 cm的患者明显多于生存组,死亡组患者的血清CA125水平明显高于生存组。Logistic回归分析结果显示,患者复发肿瘤数量>3个、有腹水、SCS术后病灶残留大小>1 cm、CA125水平高是SCS联合TC化疗治疗后患者死亡的独立危险因素(P<0.05)。结论SCS联合化疗治疗能有效提高治疗疗效,缓解临床症状,提高患者生存率,延长患者的生存时间,SCS联合化疗预后生存情况受到复发肿瘤数量、有无腹水、SCS术后病灶残留大小、CA125水平等多种因素的影响,及时采取适宜的方案可提高患者预后生存情况。Objective To investigate the prognosis and influencing factors of secondary cytoreductive surgery(SCS)combined with chemotherapy in the treatment of recurrent ovarian cancer.Methods A total of 102 patients with recurrent ovarian cancer admitted to our hospital from Jun.2012 to Jun.2015 were selected and grouped according to treatment methods.31 patients who received paclitaxel/carboplatin(TC)chemotherapy were included in the control group,and 71 patients who received SCS combined with TC chemotherapy were included in the observation group.Clinical efficacy and 5-year survival outcome of the two groups after treatment,were compared and factors affecting the prognosis of the observation group were analyzed.Results The total effective rate,1-year survival rate,3-year survival rate,and 5-year survival rate of the observation group were significantly higher than those of the control group.The median survival time of the observation group was 52 months and was significantly longer than that of the control group by 17 months(P<0.05);There was no statistical difference between the death group and the survival group in terms of age,pathological type,tissue differentiation,recurrence tumor size,or location of recurrence tumors.The number of patients with FIGO stage IV,more than 3 recurrent tumors,ascites and residual lesion size>1 cm in the death group were significantly larger than those in the survival group.The serum CA125 level of patients in the death group was significantly higher than that in the survival group.Logistic regression analysis showed that the number of recurring tumors>3,with ascites,and residual lesions>1 cm,and high level of CA125 were independent risk factors for death after SCS combined with TC chemotherapy(P<0.05).Conclusions SCS combined with chemotherapy can effectively improve the therapeutic effect,relieve the clinical symptoms,improve the survival rate of patients,and prolong the survival time of patients.The prognosis of SCS combined with chemotherapy is affected by the number of recurrent tu

关 键 词：二次肿瘤细胞减灭术 化疗 复发性卵巢癌 

分 类 号：R588.6[医药卫生—内分泌]