卵巢恶性肿瘤的阑尾转移

Appendiceal metastasis in primary ovarian cancer.

本文报道39例因原发性卵巢恶性肿瘤手术而作阑尾切除者,就其转移情况作一探讨。其中上皮性癌28例,其它类型卵巢恶性肿瘤11例。临床分期:Ⅰ期8例,Ⅱ期1例,Ⅲ期23例,Ⅳ期2例,复发5例。发现阑尾转移13例。其中晚期(Ⅲ、Ⅳ期)患者的转移率为44%(11/25),复发者中2例伴有阑尾的转移(2/5)。阑尾转移均发生在晚期或复发患者,且均伴有盆腹腔其它部位的转移或复发灶。Ⅰ、Ⅱ期者无阑尾转移。未发现阑尾的隐性转移病例。就上皮性卵巢癌而论,阑尾转移情况亦如此。本组资料表明,卵巢癌Ⅰ、Ⅱ期患者不必常规切除阑尾,而晚期患者是否需常规切除阑尾亦值得探讨。

Objective:To investigate the incidence of appen- diceal metastasis in patients with primary ovarian can- cer and evaluate the role of appendectomy in surgical treatment of primary epithelial ovarian cancer.De- sign:All cases of primary ovarian cancer admitted to our hospital from January 1980 to December 1993 have been reviewed.There were 39 patients (including 28 cases with epithelial ovarian cancer and 11 cases with other ovarian cancers)who underwent appendec- tomy during surgical treatment.Results:The incidence of appendiceal metastasis was 33%(13/39)in overall patients with ovarian cancer,44%(11/25)in patients with advaeed cancer(stage Ⅲ/Ⅳ)and 40%(2/5)with recrrence.All metastases to aprendices occured only in patients with advanced or intraperitoneal recurrent disease and were accompanied by the metastases or re- currence in other parts of the intraperitoneal cavity. No patients with early disease had appendiceal metas- tasis.We did not find occult (microscopic only)involve- ment of the appendix.Conclusion:This study showed that routine appendectomy is not necessary for pa- tients with early stage epithelial ovarian cancer and whether it is necessary for patients with advanced dis- ease is worth further studing when the appendix is normal.