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目的评价晚期卵巢上皮性癌(advanced epithelial ovarian cancer,AEOC)患者实施间歇性肿瘤细胞减灭术(interval debulking surgery,IDS)中与初次肿瘤细胞减灭术残余病灶变化对初次术后化疗疗效判断及评价预后的意义。方法选择2006年1月至2013年8月高州市中医院妇科收治的52例AEOC患者,均行IDS。按与初次手术后残余病灶变化程度分为Ⅰ组(24例)、Ⅱ组(20例)及Ⅲ组(8例)。随访14~106个月,比较3组患者辅助化疗疗效、总生存时间(overall survival,OS)及疾病未进展生存时间(progression free survival,PFS)。结果 3组残余病灶评价化疗有效率、术后病理检查评价有效率以及复发率比较差异均有统计学意义(P<0.05)。Ⅰ组患者的PFS、OS均优于Ⅱ、Ⅲ合并组。Ⅰ组与Ⅱ、Ⅲ合并组化疗中位总疗程数≥8次者的PFS及OS优于<8次者。结论 AEOC患者在IDS中与初次手术残余病灶的变化能对辅助化疗的疗效进行初步判断并评价预后,可指导下一步的治疗策略。
Objective To evaluate the effect of initial postoperative chemotherapy on patients with advanced epithelial ovarian cancer (AEOC) treated with intermittent tumor debulking surgery (IDS) Evaluation of the significance of the prognosis. Methods From January 2006 to August 2013, 52 patients with AEOC admitted to Gynecology Hospital of Gaozhou Chinese Medicine Hospital underwent IDS. According to the degree of remnant lesion after primary surgery, the patients were divided into group Ⅰ (24 cases), group Ⅱ (20 cases) and group Ⅲ (8 cases). The patients were followed up for 14 to 106 months. The adjuvant chemotherapy efficacy, overall survival (OS) and progression free survival (PFS) were compared among the three groups. Results Residual lesions in 3 groups were evaluated on the effective rate of chemotherapy, postoperative pathological evaluation of effective rate and recurrence rate were statistically significant (P <0.05). Patients in group Ⅰ had better PFS and OS than those in group Ⅱ and Ⅲ. The PFS and OS of group Ⅰ and Ⅱ, Ⅲ in the group with the median total number of courses ≥8 were better than <8. Conclusion The changes of residual lesions in patients with AEOC and initial surgery in patients with AEOC can make a preliminary judgment on the curative effect of adjuvant chemotherapy and evaluate the prognosis, which can guide the next treatment strategy.