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目的 总结单纯性卵巢未成熟型畸胎瘤肝脏周围复发的特点 ,探讨其正确诊断和治疗方案。方法 采用回顾性分析方法 ,对 18例肝脏周围复发的单纯性卵巢未成熟型畸胎瘤患者的临床分期、手术、化疗以及其原发、复发肿瘤的病理 ,结合长期随诊结果进行综合分析。结果 本组患者平均发病年龄为 2 4 8岁 ,初次手术 38 8%患者行单侧附件切除术 ,6 1 1%为临床Ⅲ期 ,4 4 4 %肿瘤病理分级为G1级 ;单纯性卵巢未成熟型畸胎瘤肝脏周围复发率为 2 8 1% ,其中接受正规化疗组患者肝脏周围复发率为 16 7% ,未行正规化疗组肝脏周围复发率为 31 2 % ;辅助诊断准确率较低 ;肝动脉插管化疗对肿瘤生长控制无效。单纯性卵巢未成熟型畸胎瘤肝脏周围复发患者随诊时间为平均 2 0 9个月 ,手术切除率为 94 4 % ,转移瘤直径 <15cm者手术并发症少 ,患者三年生存率为 77 8% ,失访率 0 0 % ;五年生存率为 55 6 % ,失访率为2 2 2 % ;十年生存率为 38 9% ,失访率为 38 9%。结论 单纯性卵巢未成熟型畸胎瘤的肝脏复发部位为肝脏周围表面 ;正规化疗是预防其肝脏周围复发的重要措施 ,但不能抑制其生长。肝动脉插管化疗的方法是错误的。适时手术可减少并发症 ,改善患者愈后
Objective To summarize the characteristics of liver recurrence in immature ovarian teratoma and to discuss its correct diagnosis and treatment. Methods Retrospective analysis was used to analyze the clinical stage, operation, chemotherapy, pathology of primary and recurrent tumors in 18 cases of simple ovarian immature teratoma with liver recurrence and the long-term follow-up results. Results The mean age at onset of this group was 24.8 years. 38.3% of the patients underwent primary unilateral excision, 61% had clinical stage III, and 44.4% had grade G1 glioma. The recurrence rate of benign teratoma around the liver was 2 8 1%. The recurrence rate of liver around the patients receiving formal chemotherapy group was 16 7%, while the recurrence rate around the liver of the patients without formal chemotherapy group was 31 2%. The accuracy of auxiliary diagnosis was lower Hepatic artery chemotherapy was ineffective in tumor growth control. Patients with simple ovarian immature teratoma around the liver recurrence were followed up for an average of 290 months, the surgical resection rate was 94.4%, metastatic tumor diameter <15cm less surgical complications, the patient’s three-year survival rate was 77 The rate of 5-year survival was 55.6% and the rate of loss to follow up was 22.2%. The 10-year survival rate was 38.9% and the rate of loss to follow-up was 38.9%. Conclusions The liver recurrence site of simple ovarian immature teratoma is the peripheral surface of the liver. Formal chemotherapy is an important measure to prevent the recurrence around the liver, but it can not inhibit its growth. Hepatic artery catheterization chemotherapy is wrong. Timely surgery can reduce complications and improve the prognosis of patients