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目的总结近20年我院晚期卵巢上皮性癌的预后状况,并对改善预后的因素进行分析。方法回顾分析1980年1月至1999年12月治疗的180例晚期卵巢癌患者的临床资料,按治疗时间分为两组,1989年12月31日以前的58例为第I组,以后的122例为第II组,对两组的临床资料包括预后进行比较,并分析影响预后的因素。结果第I组2年、5年生存率分别为18.9%、3.5%,第II组分别为57.7%、31.9%,第II组的预后明显好于第1组。单因素分析显示IIIa、IIIb期较IIIc期和IV期预后好;残余瘤≤2cm者比残余瘤>2cm者预后好;术后联合化疗≥6个疗程者较<6个疗程者预后好;TP方案或加用其他二线药物化疗者较CAP或CP方案化疗者预后好,两者均较未化疗或单一药物或非规范的联合化疗者预后好。COX逐步回归多因素分析显示,仅残余瘤大小及化疗疗程数对预后有影响。结论晚期卵巢上皮性癌的预后近10年来得到了明显改善,肿瘤细胞减灭术、CAP或TP方案6个或以上疗程的化疗有助于提高晚期卵巢癌患者的5年生存率。
Objective To summarize the prognosis of advanced epithelial ovarian cancer in our hospital in recent 20 years and to analyze the factors that can improve prognosis. Methods The clinical data of 180 patients with advanced ovarian cancer who were treated from January 1980 to December 1999 were retrospectively analyzed. According to the treatment time, they were divided into two groups. 58 cases before December 31, 1989 were Group I, and the later 122 In the case of Group II, the clinical data of both groups, including the prognosis, were compared and the factors influencing the prognosis were analyzed. Results The 2-year and 5-year survival rates of group I were 18.9% and 3.5% respectively, and those of group II were 57.7% and 31.9% respectively. The prognosis of group II was significantly better than that of group I. Univariate analysis showed that the prognosis of stage IIIa and IIIb was better than that of stage IIIc and IV; the prognosis of residual tumor> 2cm was better than that of residual tumor> 2cm; the prognosis of patients with more than 6 courses of postoperative chemotherapy was better than that of <6 courses; TP Prophylaxis with either second-line chemotherapy or CAP or CP chemotherapy was better than either chemotherapy or single-drug or non-canonical combination chemotherapy. Cox stepwise regression multivariate analysis showed that only the size of the residual tumor and the number of chemotherapy courses have an impact on the prognosis. Conclusion The prognosis of advanced epithelial ovarian cancer has been significantly improved over the past 10 years. Chemotherapy for 6 or more cycles of CAP or TP regimen has been shown to improve 5-year survival in patients with advanced ovarian cancer.