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目的探讨非生殖道来源的转移性卵巢癌的治疗方法与预后因素。方法回顾性分析武汉大学中南医院妇瘤科从1998年1月至2004年2月收治的34例非生殖道来源的转移性卵巢癌患者的临床病理资料。根据治疗方法的不同分为4组,A组(7例):行满意的肿瘤细胞减灭术;B组(9例):行满意的肿瘤细胞减灭术+术后系统化疗;C组(14例):行不满意的肿瘤细胞减灭术;D组(4例):行不满意的肿瘤细胞减灭术+术后系统化疗。对各组患者的生存时间及预后影响因素进行比较分析。结果非生殖道来源的转移性卵巢癌占同期收治的卵巢癌患者的8.8%。34例患者中,31例(91%)来源于胃肠道,2例(6%)来源于乳腺,1例(3%)来源不明。A、B、C、D组患者的中位数生存时间分别为5.0、10.0、4.0、6.5个月,除A组与B组、B组与C组、C组与D组间比较,差异有统计学意义(P<0.05)外,其余各组间比较,差异均无统计学意义(P>0.05)。单因素和多因素分析均显示,术后残留灶直径及术后系统化疗是影响预后的因素。结论非生殖道来源的转移性卵巢癌主要来源于胃肠道肿瘤,此类患者应予满意的肿瘤细胞减灭术,术后再辅以系统化疗,能显著改善患者的预后。
Objective To investigate the treatment and prognostic factors of non-genital tract-derived metastatic ovarian cancer. Methods The clinical and pathological data of 34 patients with non-genital tract metastatic ovarian cancer who were admitted to Department of Gynecology and Obstetrics of Zhongnan Hospital of Wuhan University from January 1998 to February 2004 were retrospectively analyzed. According to the different treatment methods, the patients were divided into four groups, group A (n = 7): satisfactory cytoreductive surgery; group B (n = 9): satisfactory cytoreductive surgery + postoperative systemic chemotherapy; group C 14 cases): unsatisfactory tumor cytoreductive surgery; Group D (4 cases): not satisfied with the cytoreductive surgery + postoperative systemic chemotherapy. Survival time and prognostic factors in each group were compared. Results Non-genital tract metastatic ovarian cancer accounted for 8.8% of patients with ovarian cancer over the same period. Of the 34 patients, 31 (91%) were from the gastrointestinal tract, 2 (6%) from the breast, and 1 (3%) from unknown sources. The median survival time of patients in groups A, B, C and D were 5.0, 10.0, 4.0 and 6.5 months, respectively, except for the difference between group A and group B, group B and group C, group C and group D Statistical significance (P <0.05), the other groups, the difference was not statistically significant (P> 0.05). Univariate and multivariate analysis showed that the diameter of postoperative residual tumor and postoperative systemic chemotherapy are the prognostic factors. Conclusion Non-genital tract metastatic ovarian cancer is mainly originated from gastrointestinal cancer. Such patients should be satisfied with tumor cytoreductive surgery and postoperative chemotherapy combined with systemic chemotherapy can significantly improve the prognosis of patients.