摘要
目的：探讨复发性卵巢恶性肿瘤再次手术的临床价值及可行性。方法：回顾性分析1995年3月至2004牟6月共111例复发性卵巢恶性肿瘤行再次手术治疗患者的临床及随访资料。根据病理类型分为上皮性卵巢癌组和其他类型癌组，根据复发距初次手术的时间分为〉6个月复发组和≤6个月复发组，再根据再次手术中所见复发转移灶数目分为单病灶组和多病灶组，最后根据再次手术后化疗的次数分为≥6个疗程组、〈6个疗程组和未化疗组。观察再次手术中满意减灭术和手术并发症的例数，分析术后生存率。各组数据比较采用X^2检验。结果：上皮性卵巢癌组和其他类型癌组中获得满意减灭术例数分别为70例和2例（X^2=5.91，P〈0.05）；初次手术后〉6个月复发组和≤6个月复发组获得满意减灭术例数分别为45例和27例（X^2=0.39，P〉0.05）；单病灶组和多病灶组获得满意减灭术例数分别为51例和21例（X^2=25.73，P〈0.05）。术后并发症主要为术中出血〉1000mL、肠梗阻、肠瘘、切口感染、尿路感染等，总发生率为22.5％，单病灶组和多病灶组手术并发症比较无统计学意义（X^2=3.81，P〉0.05）。予以术后补救化疗后，≥6个疗程组、〈6个疗程纽和未化疗纽术后中位生存期分别是12个月、9个月和2个月。术后1-5年生存率分别为83.7％、69.5％、58.6％、42.3％、29.2％。结论：对于单个复发病灶及初次手术后〉6个月复发的上皮性卵巢癌患者实施再次手术是可行的，术后予以补救化疗可提高治疗的有效性，延长生存时间。
Objective： To investigate the feasibility of recytoreductive surgery for recurrent ovarian carcinoma. Methods： The clinical and surgical data of 111 cases with recurrent ovarian carcinoma seen in our hospital between 1995 and 2004 were retrospectively analyzed. They were divided into two groups according to the pathological type. Group 1 were patients with epithelial ovarian carcinoma and Group 2 were patients with non-epithelial ovarian carcinoma. The patients were also divided into two groups according to the time between the first surgery and the relapse. （Group A, more than six months; Group B, less than six months）. According to the recurrent lesion, these patients were divided into two groups （Group α, single-lesion; Group β, multi-lesion）. According to the periods of chemotherapy after the secondary surgery, the patients were divided into three groups （Group Ⅰ, more than six periods; Group Ⅱ, less than six periods; Group Ⅲ, without receiving chemotherapy）. We reviewed the cases with regard to its macroscopic residual disease, complications of surgery and postoperative survival rate. Chi-square test was used for statistical analysis. Results： The number of cases with satisfactory results of recytoreductive surgery in group 1 and 2 was 70 and 2, respectively （X^2= 5.91, P〈0.05）. In group A and B, it was 45 and 27, respectively（X^2=0.39, P〉0.05）; and in group α and β, it was 51 and 21, respectively（X^2=25.73, P〈0.05）. Postoperative complications occurred in 22.5% patients, including blood loss〉1000mL, intestinal obstruction, intestinal fistula, abdominal wound infection and urinary tract infection, etc. There was no significant difference in complications between the singe-lesion group and the multi-lesion group （X^2=3.81, P〉0.05）. The median survival of group Ⅰ, Ⅱ and Ⅲ was 12 months, 9 months and 2 months, respectively. The overall 1-, 2-, 3-, 4- and 5-year survival rates were 83.7%, 69.5%, 58.6%, 42.3% and 29.2%, respectively. Conclusion： Recyto
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第22期1277-1280,共4页
Chinese Journal of Clinical Oncology
关键词
卵巢肿瘤
肿瘤复发
再次手术
Ovarian carcinoma
Recurrence
Recytoreductive surgery
