论文部分内容阅读
目的 探讨Ⅳ期卵巢上皮性癌的肿瘤细胞减灭术的意义和预后因素。方法 回顾性分析我院 1986年 1月至 1997年 12月 ,经手术病理分期的Ⅳ期卵巢上皮性癌 71例 ,其中切净组 (残留灶≤ 1cm) 30例 ,未切净组 (残留灶 >1cm) 4 1例。结果 手术切净率为 42 .3%。Ⅳ期卵巢上皮性癌各转移部位中 ,锁骨上淋巴结转移和胸膜转移患者切净组的预后明显好于未切净组 (P <0 .0 5 )。Ⅳ期卵巢上皮性癌的总 5年生存率为 6 .1% ,其中切净组与未切净组的 5年生存率分别为 13.7%和 0 .0 % ,中位生存期分别是 2 3个月和 9个月 ,分别比较 ,差异均有极显著性 (P <0 .0 0 1)。COX模型逐步回归结果表明 ,残留灶直径 >1cm和腹水是预后的危险因素 (P <0 .0 5 )。化学治疗与预后无关。结论 肿瘤细胞减灭术对Ⅳ期卵巢上皮性癌 ,尤其是锁骨上淋巴结和胸膜有转移者有肯定的治疗价值。
Objective To investigate the significance and prognostic factors of cytoreductive surgery in stage IV ovarian epithelial carcinoma. Methods A retrospective analysis of 71 patients with stage Ⅳ ovarian epithelial carcinoma staged by surgical pathology from January 1986 to December 1997 in our hospital was performed. Among them, there were 30 cases of resection group (≤ 1 cm) > 1cm) 4 1 cases. Results Surgical resection rate was 42.3%. Ⅳ stage epithelial ovarian cancer metastatic sites, supraclavicular lymph node metastasis and pleural metastasis in patients with cleaved group was significantly better than the net group was not significantly improved prognosis (P <0.05). The overall 5-year survival rate of stage IV ovarian epithelial carcinoma was 6.1%. The 5-year survival rates of the group with and without incision were 13.7% and 0.0% respectively, and the median survival time was 23 Months and 9 months, respectively, the differences were significant (P <0.001). The stepwise regression of the COX model showed that residual lesions> 1 cm in diameter and ascites were prognostic risk factors (P <0.05). Chemotherapy has nothing to do with the prognosis. Conclusions Tumor cytoreductive surgery has positive therapeutic value on stage IV ovarian epithelial carcinoma, especially on supraclavicular lymph nodes and pleural metastasis.