非生殖道来源的转移性卵巢癌的治疗及预后

Management and prognosis of metastatic ovarian carcinoma from nongenital tract

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 study the management and prognosis of nongenital metastatic ovarian carcinoma. Methods Thirty-four patients with nongenital metastatic ovarian carcinoma who were admitted in to Zhongnan Hospital of Wuhan University between 1998 and 2004 were analyzed retrospectively. Results The median survival time of group A (optimal cytoreductive surgery), group B (optimal cytoreductive surgery+chemotherapy), group C (sub-optimal cytoreductive surgery) and group D (sub-optimal cytoreductive surgery+chemotherapy ) was 5.0,10.0,4.0 and 6.5 months, respectively. The difference was significant between groups A and B, B and C, as well as between group C and D(P<0.05). Conclusions Most of nongenital metastatic ovarian carcinomas come from tumors of stomach and intestine. Optimal cytoreductive surgery and chemotherapy play an important role in the management and prognosis of nongenital metastatic ovarian carcinoma.