卵巢外腹膜浆液性乳头状癌与卵巢浆液性乳头状癌比较分析

Comparison of primary extraovarian peritoneal serous papillary carcinoma with stage Ⅲ-Ⅳ ovarian papillary serous carcinoma

目的 探讨卵巢外原发腹膜浆液性乳头状癌 (EPSPC)的临床和治疗特点及预后。方法回顾性分析 12例EPSPC与 4 5例Ⅲ、Ⅳ期卵巢浆液性乳头状癌 (OPSC)的临床和随访资料 ,比较其临床及治疗特点、对一线化疗药物的敏感性及生存时间。结果 EPSPC与OPSC两组的症状、体征、CA12 5水平、无瘤期、复发时间、对一线化疗药物的反应及生存时间差异无统计学意义 ,而EPSPC组的完全缓解率 (2 5 .0 % )与OPSC组 (91.8% )比较 ,显著降低 (P <0 .0 1)。结论 EPSPC与OPSC临床过程类似 ,当治疗手段相同时 ,对一线化疗药物的敏感性及生存时间相近。

Objective Extraovarian peritoneal serous papillary carcinoma (EPSPC) is both histologically and clinically similar to stage Ⅲ Ⅳ ovarian papillary serous carcinoma (OPSC). The purpose of this study is to investigate the clinical findings, treatment, and outcome of EPSPC patients compared with stage Ⅲ Ⅳ OPSC patients. Methods The data of 12 EPSPC patients and 45 stage Ⅲ Ⅳ OPSC patients were retrospectively reviewed, comparing the characteristics on clinical presentation and treatment, sensitivity to first line chemotherapy agents and survival. Results By analysis of patients′ characteristics, presenting signs and symptoms, type and extent of surgery, tumor response to first line chemotherapy, recurrence free interval, recurrence site and serum CA 125 levels, no significant difference was observed between the EPSPC patients and stage Ⅲ Ⅳ OPSC controls. The prevailing presenting symptoms were abdominal mass and ascites. The mainstay of treatment was debulking surgery followed by adjuvant platinum based chemotherapy. The complete clinical response of stage Ⅲ Ⅳ OPSC was 91.8% compared with 25.0% for women with EPSPC( P <0.01). Conclusion The clinical and surgical characteristics of EPSPC are similar to those of stage Ⅲ Ⅳ OPSC. When the same treatment strategy is applied, similar response and survival are expected in either condition.