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目的 为了解晚期卵巢癌手术加化疗后取得临床完全缓解的病人腹腔肿瘤的情况 ,以决定治疗方案。方法 对我院基本符合二次探查定义的 12例上皮性卵巢癌病人进行了“二探术”,平均年龄 5 0 .5岁 , 期 1例 , 期 9例 , 期 2例。以铂类药物为主的腹腔静脉联合化疗 6～ 12疗程 ,平均 9.2疗程。结果 二探距第一次手术时间多在 12～ 14个月 ,12例中肉眼见肿瘤 2例 ,镜下阳性 2例 ,阳性率 33.3% ,均在二探术后 1年内及 1年左右死亡。 8例二探阴性 ,阴性率 6 6 .7% ,有 2例复发 (复发率 16 % ) ,均于复发后 1年左右死亡 ,目前无瘤存活 6例 ,分别存活 4～ 14年。结论 本组二探结果与临床期别、残瘤大小有密切关系 ,对 期以上的卵巢癌化疗 6疗程是不够的。二探阴性率高于文献、复发率低于文献可能与病例少有关。由于观念及技术、经济问题病人难以接受 ,加之二探对卵巢癌治疗帮助不大 ,手术有损伤和危险 ,技术要求高 ,建议尽量用其它方式代替。二探只能选择少量有条件的病人进行
Objective To understand the advanced ovarian cancer surgery and chemotherapy patients achieved complete remission of peritoneal tumors, to determine the treatment options. Methods A total of 12 cases of epithelial ovarian cancer patients who met the definition of secondary exploration in our hospital underwent “two detectives”, with an average age of 50.5 years, of which 1 was in stage, 9 in stage and 2 in stage. Platinum-based drugs combined with intraperitoneal chemotherapy 6 to 12 courses, an average of 9.2 courses. Results Second probing time was 12 to 14 months after the first operation. In 12 cases, the tumor was found in 2 cases with macroscopic findings and in 2 cases with positive microscopy. The positive rate was 33.3%, both within 1 year and within 1 year after the second exploration . The second test was negative in 8 cases, with a negative rate of 66.7%. There were 2 cases of recurrence (the recurrence rate was 16%), all of which died about 1 year after recurrence. There are 6 cases with no tumor at present and survive for 4 ~ 14 years respectively. Conclusion The results of the second group of this group and the clinical stage, the size of the residual tumor are closely related to chemotherapy over the period of 6 cycles of ovarian cancer is not enough. Second, the negative rate was higher than the literature, the recurrence rate lower than the literature may be related to less cases. As the concept and technology, economic problems, patients unacceptable, combined with the second exploration of ovarian cancer treatment is not helpful, there is injury and danger of surgery, high technical requirements, it is recommended to try to use other means instead. Second exploration can only choose a small number of conditional patients