64例上皮性卵巢癌的临床及预后分析

The clinical and prognostic analysis of 64 cases with epithelial ovarian cancer

目的:探讨影响上皮性卵巢癌预后的因素。方法:对64例卵巢上皮性癌的病例资料进行回顾性分析, 26例早期(Ⅰ-Ⅱ)病人以全子宫切除加双附件切除为主,38例晚期(Ⅲ级及以上)以肿瘤减灭术为主,术后化疗以 CAP方案为主(环磷酰胺、阿霉素、顺氯氨铂)。结果:早期患者存活率明显高于晚期患者(P<0．01)。38例晚期患者中,理想的肿瘤减灭术(无残灶或残灶<2 cm)者存活率明显高于不理想的肿瘤减灭术(残灶≥2 cm)者(P <0．05)。术后化疗次数≥6次者与<6次者存活率差异有统计学意义(P<0．05)。分化程度对预后有明显影响 (P<0．05),但年龄及病理类型对预后影响差异无统计学意义(P>0．05)。肿瘤的临床分期、残灶大小及化疗次数对预后影响较大。结论:早期诊断、首次手术彻底以及化疗疗程≥6次是改善上皮性卵巢癌预后的关键。

Objective： To investigate the prognostic factors of epithelial ovarian carcinoma. Methods.. The clinical data and follow-up data of 64 patients with epithelial ovarian carcinoma who were treated in our hospital between Feb 1995 to Feb 2005 were retrospectively studied. Results.. The median survival of 64 patients with epithelial ovarian carcinoma was 26 months. The survival rate of patients in early stage （FIGO stage Ⅰ and Ⅱ ） was significantly higher than that of patients in advanced stage （FIGO stage Ⅲ ） （P〈 0.01）. All patients received surgical therapy. Among advanced stage of patients, good cytoreductive surgery （no residue or residue〈2 cm） were performed in 20 patients and their survival rate was significantly higher than these of 18 unsuccessful cases（residue≥2 cm ）, 26 patients undertook 6 or more courses of chemotherapy their survival rate was also significantly higher than that of 38 patients who undertook less than 6 courses. The survival rate of patients with different pathological grade had significant difference （P〈0.05）. Clinical stage, size of residue and the courses of chemotherapy were independent prognostic factors. Conclusion： Early diagnosis, primary optimal cytoreductive surgery and 6 or more courses of chemotheraphy might improve the survival of patients with epithelial ovarian carcinoma.