论文部分内容阅读
目的:探讨原发性腹膜癌的临床特点,诊断标准,治疗方法及预后。方法:对本院收治的15例原发性腹膜癌的临床资料进行回顾性分析,以腹胀、腹水、食欲不振、消瘦为首发症状(100%)。15例均行肿瘤减灭术,病理为盆腹腔腹膜广泛种植的中、低分化浆液性乳头状腺癌,12例伴砂粒体,2例卵巢浅表受侵。术后给予CAP(顺铂、阿霉素、环磷酰胺)或TP(紫杉醇、顺铂)化疗,平均8.4个疗程。结果:随访<2年4例,均无瘤生存。>2年11例,仅1例死于癌,2年生存率90.9%(10/11),3年生存率54.5%(6/11),5年生存率18.2%(2/11)。Ⅲ和Ⅳ期3年生存率各为83.3%(5/6)和25.0%(1/4),5年生存率各为33.3%(2/6)和0。残存肿瘤<2cm和>2cm,3年生存率各为50.0%(3/6)和33.3%(3/9),5年生存率各为33.3%(2/6)和0。结论:临床应警惕腹胀、腹水患者的卵巢外腹膜浆液性乳头状癌(EPSPC)的诊断。积极减瘤术和术后辅助顺铂为基础的化疗,是提高患者生存率的主要因素。
Objective: To investigate the clinical features, diagnostic criteria, treatment methods and prognosis of primary peritoneal carcinoma. Methods: The clinical data of 15 patients with primary peritoneal carcinoma admitted to our hospital were retrospectively analyzed. The symptoms of abdominal distention, ascites, loss of appetite, and weight loss were the first symptoms (100%). All the 15 patients underwent tumor resection. The pathology was moderately-differentiated serous papillary adenocarcinoma, which was extensively planted in the peritoneum of the pelvis and abdomen. Twelve cases were accompanied by sand bodies, and 2 cases were superficially invaded. Postoperative CAP (cisplatin, doxorubicin, cyclophosphamide) or TP (paclitaxel, cisplatin) chemotherapy was administered, with an average of 8.4 cycles. RESULTS: Four patients were followed up for <2 years and all had no tumor survival. In 11 years of 2 years, only 1 patient died of cancer, the 2-year survival rate was 90.9% (10/11), the 3-year survival rate was 54.5% (6/11), and the 5-year survival rate was 18.2% (2/11). The 3-year survival rates for stage III and IV were 83.3% (5/6) and 25.0% (1/4), respectively, and the 5-year survival rates were 33.3% (2/6) and 0, respectively. The remaining tumors were <2cm and >2cm, and the 3-year survival rates were 50.0% (3/6) and 33.3% (3/9), respectively. The 5-year survival rates were 33.3% (2/6) and 0, respectively. Conclusion: The diagnosis of ovarian extraperitoneal serous papillary carcinoma (EPSPC) in patients with bloating and ascites should be monitored clinically. Active cytoreductive surgery and postoperative adjuvant cisplatin-based chemotherapy are major factors in improving patient survival.