摘要
目的: 探讨晚期卵巢癌能否行手术治疗的预测因素及新辅助化疗在晚期卵巢癌中的临床价值方法:回顾性分析了大连医科大学附属第一医院1996年1月至2008年12月收治的Ⅲ～Ⅳ期晚期卵巢癌病例92例,其中18例接受新辅助化疗(NAC组),74例接受初次手术(PCS组)。结果:使初次肿瘤细胞减灭术满意率降低的因素:伴有合并症(P=0.022);初次治疗时存在胸腔积液(P=0.011);CA125>1 000 U/L(P=0.030);有肝、肺转移的Ⅳ期患者(P=0.031)。新辅助化疗的总有效率为66.7%。新辅助化疗可以提高肿瘤细胞减灭术的满意率(P=0.022),缩短引流管置留天数(P=0.011),减少腹水量(P=0.005)、术中出血量(P=0.048),但在手术时间、输血量、平均住院天数、患者生存时间方面,NAC组与PCS组的差异无统计学意义(P>0.05)。结论:伴有合并症、胸腔积液、CA125>1 000U/L、临床分期为Ⅳ期、表现为肝、肺转移的患者适合新辅助化疗。新辅助化疗可以提高肿瘤细胞减灭术的满意率,减少术中、术后并发症,可能会改善患者预后。
Objective： To determine the factors affecting primary optimal surgery and the clinical significance of neoadjuvam chcmotherapy （ NAC ） on advanced epithelial ovarian cancer. Methods： From January1996 to December 2008,92 cases with advanced epithelial ovarian cancer （ stages Ⅲc～Ⅳ ） were retrospectively analyzed. NAC was performed in 18 cases, while the rest underwent primary cytoreductive surgery followed by platinum-based chemotherapy. Results： Suboptimal debulking was statistically associated with patients having complications （ P= 0.022 ）, cavity hydrops （ P= 0.011 ）, CA125 〉 1000 U/L （ P= 0.03 ）, and liver or pulmonary metastasis （ P 0.031 ）. The total effective rate of NAC was 66.7%. The rate of gross excision was significantly higher （ P 0.022 ）. It also shortened the remaining time of the drain pipe （ P- 0.011）, decreased ascites （ P = 0.005 ）, and blood loss （ P = 0.048 ）. However, the time spent in surgery, blood transfusion, hospital stay, and overall survival rate showed no significant difference （ P 〉 0.05 ）. Conclusions： NAC can enhance the gross excision rate of advanced ovarian cancer and decrease the incidence of intraoperative and postoperative complications. It may also improve the prognosis of patients with advanced ovarian cancer.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2011年第14期850-854,共5页
Chinese Journal of Clinical Oncology
关键词
晚期卵巢癌
新辅助化疗
肿瘤细胞减灭术
生存
Advanced ovarian cancer
Neoadjuvant chemotherapy
Cytoreductive surgery
Survival
