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目的评价肿瘤细胞减灭术治疗复发上皮性卵巢癌(EOC)的作用,分析影响生存时间的因素。方法按Cochrane系统评价方法,计算机检索PubMed、EMbase、Medline、Cochrane Library、循证医学数据库(EBMR)、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CJFD)、清华同方等数据库,并手工检索相关领域杂志。检索时间从1985年1月1日-2011年11月30日,查找手术治疗复发EOC患者的回顾性、非随机前瞻性、病例对照研究,由两位研究者按照纳入排除标准筛选文献、评价质量并提取资料后,采用SPSS软件进行线性回归分析。结果共纳入48篇文献(回顾性文献40篇,非随机前瞻性文献7篇,病例对照研究1篇)共2 605例。简单线性回归分析结果显示满意切除比例与中位生存时间回归模型成立,有统计学意义(F=7.346,P=0.009),浆液性病理类型比例与中位生存时间回归模型成立,有统计学意义(F=5.537,P=0.025),残留病灶大小与中位生存时间回归模型成立,有统计学意义(F=4.249,P=0.045),多重逐步线性回归分析显示仅有满意切除比率对术后中位生存时间的影响有统计学意义(P=0.009)。结论二次肿瘤细胞减灭术主要适用于铂类敏感型可切除及孤立结节复发EOC患者,要获得明确二次肿瘤细胞减灭术治疗复发EOC对中位生存时间的影响,尚需进行大样本随机对照的研究。
Objective To evaluate the role of cytoreductive surgery in the treatment of recurrent epithelial ovarian cancer (EOC) and to analyze the factors that influence the survival time. Methods According to the Cochrane systematic review method, PubMed, EMbase, Medline, Cochrane Library, EBMR, CBM, CJFD and Tsinghua Tongfang were searched by computer. Retrieve relevant magazines. Retrieval time From January 1, 1985 - November 30, 2011, a retrospective, non-randomized, prospective, case-control study was performed to find out the surgical treatment of recurrent EOC. Two investigators screened the literature according to inclusion criteria and evaluated the quality And after extracting the data, using SPSS software for linear regression analysis. Results A total of 48 articles were included (retrospective 40, non-random, prospective 7, and case-control 1). The results of simple linear regression analysis showed that the satisfactory resection rate was positively correlated with the median survival time regression model (F = 7.346, P = 0.009), and the proportion of serous pathological type to median survival time regression model was statistically significant (F = 5.537, P = 0.025). The regression model between residual disease size and median survival time was established (F = 4.249, P = 0.045). Multiple stepwise linear regression analysis showed that only satisfactory resection rate The median survival time was statistically significant (P = 0.009). Conclusions Secondary cytoreductive surgery is mainly suitable for patients with platinum-sensitive resectable or isolated nodules with recurrent EOC. To confirm the effect of secondary cytoreductive surgery on the median survival time, we need to conduct large A sample of randomized controlled studies.