摘要
目的分析非生殖器官来源转移性卵巢癌(MOCNGO)的临床特点和预后因素,探索其诊治方法。方法回顾性分析1995年至2007年收治的MOCNGO 27例的临床资料,患者中位年龄40岁,未绝经者22例,有生育史者25例;原发部位:胃6例、大肠17例、乳腺4例;原发肿瘤Ⅳ期19例、Ⅲ期6例、分期不明2例;双侧卵巢同时受累者19例;有腹腔广泛转移者16例;腹水≥1 500 ml者11例;卵巢肿瘤直径<10 cm者13例,≥10 cm者14例。对其进行生存分析,探讨影响其预后的主要因素。结果全组2年生存率为22.03%,中位生存时间(14.00±3.36)个月。原发灶根治性切除组、卵巢肿瘤发生时间>1年组、单侧卵巢受累组预后优于原发灶姑息性切除/探查术组、卵巢肿瘤发生时间<1年组、双侧卵巢受累组,P值均<0.005。结论非生殖器官来源卵巢转移癌预后差;对于绝经前期、有生育史的胃肠道或乳腺晚期腺癌者尤应注意排除卵巢转移的可能性,而绝经前期、有生育史卵巢肿瘤病例则应重视胃肠道和乳腺的检查;当胃癌发生卵巢转移时尤应注意避免过度治疗,而乳腺癌、大肠癌发生卵巢转移者应积极剖腹探查及化疗。
Objective This study was designed to analyzed the clinical characteristics and prognostic factors of metastatic ovarian carcinoma from nongenital organs （ MOCNGO）, as well as to discuss its diagnosis and management. Methods Median age was 40.22 cases were premenopausal women and 25 cases have fertility history. Original site ：6 cases from stomach, 17 cases from colon,and 4 cases from breast. Stage of the primary was as follows：stage Ⅳ in 19 cases,stage Ⅲ in 6,and unknown in 2.19 cases were bilateral ovary involved. 16 cases were found with extensive abdominal metastasis. 11 cases had peritoneal dropsy more than 1 500 ml. Diameter of the ovarian tumor larger than 10 cm were found in 14 cases, while smaller than 10 in 13 cases. Clinical data of 27 cases of MOCNGO were retrospectively studied. Results Overall 2-year-survival in this series was 22.03% ,with median survival time of 14.00 ± 3.36 months. Radical ablation of the primary, involvement of the ovary after treatment of the primary later than 1 year, and monolateral ovary involvement had survival prestige over the otherwise. Conclusion Prognosis of MOCNGO is poor. For patients with advanced gastrointestinal tract andenocarcinoma or breast adenocarcinoma, who are premenopause women and have fertility history, additional attention should be paid to exclude of ovarian metastasis, while for ovarian tumor patients who are premenopause women and have fertility history, examination of the gastrointestinal tract and breast should be emphasized. Over treatment should be avoided for gastric carcinoma with ovarian metastasis, while abdominal exploration and chemotherapy should be considered for ovarian metastasis from colon and breast.
出处
《实用癌症杂志》
2008年第5期510-512,共3页
The Practical Journal of Cancer
关键词
卵巢肿瘤
转移肿瘤
生存分析
Ovarian neoplasm
Metastatic tumor
Survival analysis
