结直肠癌卵巢转移的外科治疗及预后分析

Surgial treatment and prognosis of ovarian metastasis from colorectal cancer

目的探讨结直肠癌卵巢转移的外科治疗及影响患者预后的因素。方法搜集67例结直肠癌卵巢转移患者的资料,预后影响因素的单因素分析采用Log rank检验,多因素分析应用Cox比例风险模型进行回归分析。结果单侧卵巢转移、单纯卵巢转移、肿瘤转移仅限于盆腔内者多行根治性切除。全组67例结直肠癌卵巢转移患者总的1、3、5年生存率分别为71.0%、18.7%和9.2%。单因素分析结果显示,单纯卵巢转移、转移灶局限于盆腔内、单侧或双侧转移、手术方式是影响结直肠癌卵巢转移患者预后的主要因素(P<0.05)。多因素分析结果显示,仅手术方式是结直肠癌卵巢转移患者预后的独立影响因素(OR=3.531,P<0.001)。结论结直肠癌卵巢转移应行积极的外科治疗,争取根治性切除,有助于延长患者的生存时间。

Objective To summarize the surgical treatment experiece and to investigate the prognosis of the patients with ovarian metastasis from colorectal cancer. Methods The data of 67 patients with synchronous or asynchronous ovarian metastasis from colorectal cancer surgically treated between January 1989 and December 2005 were collected and analyzed retrospectively using Statistical Package for the Social Sciences （ Release 11.5, SPSS, Inc ）. Prognostic factors were analyzed using x^2 test. Survival analysis was estimated by the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis was carried out by Cox regression. Results The overall 1-, 3- and 5-year survival of these 67 patients was 71.0%, 18.7% and 9.2% , respectively. Univariate analysis revealed that the metastasis was confined in the ovary or pelvis only, unilateral/double ovarian metastasis, and operation mode were all statistically significant prognostic factors（ P 〈0.05 ）. Cox regression analysis showed that the operation mode was the most important prognostic factor （ OR = 3.531, P 〈 0.001 ）. Conclusion Surgical treatment is still the most effective mode in the treatment for the ovary metastasis from colorectal cancer.