县域卵巢癌诊疗管理路径与质量控制指南(2025版)  

Guidelines for diagnosis,treatment management pathways,and quality control of ovarian cancer in county-level regions(2025 edition)

作　　者：国家肿瘤质控中心卵巢癌专家委员会 高庆蕾[2] 马丁[3] 尹如铁 王纯雁[5] 周颖[6] 李华商 杨文静 杨娟 申郁冰 Expert Committee on Ovarian Cancer,National Cancer Quality Control Center;Gao Qinglei;Ma Ding(不详;Department of Gynecologic Oncology,Tongji Hospital,Tongji Medical College of HUST Huazhong University of Science and Technology,National Clinical Research Center for Obstetrical and Gynecological Diseases,Wuhan 430030,China;Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College of HUST,Huazhong University of Science and Technology,National Clinical Research Center for Obstetrical and Gynecological Diseases,Wuhan 430030,China)

机构地区：[1]不详 [2]华中科技大学同济医学院附属同济医院妇科肿瘤科,国家妇产疾病临床医学研究中心,武汉430030 [3]华中科技大学同济医学院附属同济医院妇产科,国家妇产疾病临床医学研究中心,武汉430030 [4]四川大学华西第二医院妇科肿瘤科 [5]辽宁省肿瘤医院妇科肿瘤科 [6]中国科学技术大学附属第一医院妇产科 [7]国家癌症中心国家肿瘤临床医学研究中心、中国医学科学院北京协和医学院肿瘤医院癌症诊治质控办公室

出　　处：《中华肿瘤杂志》2025年第3期201-210,共10页Chinese Journal of Oncology

基　　金：国家重点研发项目(2022YFC2704200、2022YFC2704205);中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-001)。

摘　　要：为制定适用于县级医院的卵巢癌诊疗管理路径与质量控制指南,规范县域卵巢癌诊疗管理,提高诊疗质量,促进优质医疗资源下沉,国家肿瘤质控中心卵巢癌专家委员会基于现有国家级卵巢癌诊疗指南规范,结合循证医学证据和临床实践经验,制定《县域卵巢癌诊疗管理路径与质量控制指南(2025版)》。指南采用路径形式,涵盖县域卵巢癌分级诊疗、诊断、治疗和随访等方面,并提出13条具体推荐意见。指南明确了县域医院在卵巢癌诊疗中的功能定位,包括初级诊治、抗肿瘤药物治疗、维持治疗、不良反应管理、复发监测、康复指导、双向转诊和随访等。对于诊疗能力不足的情况,建议及时转至上级医院或有条件的县域医院。有条件的县域医院可开展早期卵巢癌手术,但高度怀疑为中晚期卵巢癌应及时转诊。指南强调县域医院应积极开展多学科综合诊疗,并建议新诊断患者的首次化疗在上级或具备条件的同级医院完成。在随访方面,县域医院可完成疾病复查,但怀疑复发或转移时应转诊上级医院评估。指南还详细阐述了诊断路径、治疗路径(包括手术、化疗、维持治疗和复发治疗)以及随访路径,并推荐结合线上随访方式,密切监测患者状况。指南通过明确县域医院在卵巢癌诊疗中的功能定位,规范转诊流程,加强多学科协作,旨在促进县域卵巢癌诊疗的规范化和标准化。指南的实施有望提高县域医院对卵巢癌的诊疗能力,加强与上级医院的协作,从而改善县域卵巢癌患者的预后和生活质量。这不仅有助于优化医疗资源配置,还将推动我国卵巢癌诊疗水平的整体提升,促进区域医疗均衡发展。To establish diagnosis,treatment management pathways,and quality control guidelines tailored to county-level hospitals,standardize ovarian cancer care,improve treatment quality,and promote the equitable distribution of high-quality medical resources,the Expert Committee on Ovarian Cancer under the National Cancer Quality Control Center formulated the"Guidelines for diagnosis,treatment management pathways,and quality control of ovarian cancer in county-level regions(2025 edition)".This guideline integrates existing national standards for ovarian cancer diagnosis and treatment with evidence-based medicine and clinical expertise.Structured as a pathway framework,this guideline addresses hierarchical diagnosis and treatment,diagnostic workflows,therapeutic approaches,and follow-up protocols for ovarian cancer in county-level settings,offering 13 specific recommendations.The guideline clarifies the roles of county-level hospitals in ovarian cancer management,including primary diagnosis and treatment,administration of antitumor therapies,maintenance therapy,adverse event management,recurrence monitoring,rehabilitation guidance,two-way referrals,and follow-up.For cases beyond local capacity,timely referral to higher-level hospitals or qualified county-level facilities is advised.County-level hospitals may perform surgery for early-stage ovarian cancer,but suspected advanced-stage cases should be promptly referred.The guideline emphasizes the importance of multidisciplinary collaboration in county-level hospitals and recommend that initial chemotherapy for newly diagnosed patients should be conducted at higher-level or adequately equipped county-level institutions.Follow-up evaluations may be performed locally,but suspected recurrence or metastasis requires referral to higher-level hospitals for assessment.Detailed pathways are provided for diagnosis,treatment(including surgery,chemotherapy,maintenance therapy,and recurrence management),and follow-up,with recommendations for incorporating online follow-up methods to enha

关 键 词：卵巢肿瘤 县域 质量控制 分级诊疗 

分 类 号：R73[医药卫生—肿瘤]