卵巢上皮性癌81例综合治疗与预后因素分析

Combined Modalify Therapy and Prognosis of 81 Cases of Epithelial Ovarian Cancer

目的 :探讨卵巢上皮性癌的治疗效果及影响因素。方法 :对 1984年 1月～ 1995年 12月在我院治疗的 81例卵巢上皮癌进行回顾性分析 ,所有病例均经病理证实 ,FIGO分期 ,Ⅰ期 11例 ,Ⅱ期 15例 ,Ⅲ期 2 9例 ,Ⅳ期 2 6例。有 7例术后未作化疗 ,其余 74例均在术后行化疗 ,12例因复发而再次化疗 ,化疗方案以FAC方案 ( 5-氟脲嘧啶 ,更生霉素 ,环磷酰胺 ) ,CAP方案 (环磷酰胺 ,阿霉素 ,顺珀 ,或卡珀 )手术后无肉眼可见肿瘤残存者 2 6例 ,肿瘤残留直径≤ 2cm者 18例 ,>2cm者 37例。结果 :总的 5年生存率为 34 56% ,Ⅰ期为 81 8% ,Ⅱ期为 60 0 % ,Ⅲ期为 2 7 59% ,Ⅳ期为 7 69% ;化疗 <8次和≥ 8次者 5年生存率为 2 7 91%和 51 61% ,无肉眼可见肿瘤残留 ,残留直径≤ 2cm及 >2cm者 5年生存率为别为 72 73%、38 4 6%、15 2 2 %。结论 :卵巢癌的分期 ,肿瘤残存直径大小 ,以及术后是否化疗均与卵巢癌的预后有关 。

Objective:To explore the efficacy of treatment and prognostic factors for epithelial ovarian cancer.Methods:From Jan.1984 to Dec.1995,81 patients admited to our hospital for treaetment were eligible for retrospective evaluation,among them 11 patients with stageⅠ,15 patients with stageⅡ,29 patients with stage Ⅲand 26 with stage Ⅳ.All the patients with ovarian cancer were given cytoreductive surgery,74 patients were given postoperative chemotherapy,FAC(5Flurouracie,kangshengmycin.Cyclophosphmaide),CAP(Cyclophosphamide,Adriamycin,Cisplatin or Carboplatin).Results:In 26patients no residual tumor was found;in 18 patients there were residual lesions less than 2 cm in diameter;in 37 patients there were residual more than 2 cm in diameter.The overall 5yearsurvival rate was 3456%,witih 818% for stageⅠ,600% for stageⅡ,2759% for stageⅢ,and 769%for stageⅣ.The 5yearsurvival rates of cases without gross residual tumor;residual lesions less than 2cm;more than 2cm in diameter were 7273%,3846%,1522% respectively.The rates of those case receiving less or more than 8 courses of chemotherapy were 2791%and 5161%.Conclusions:The prognosis of epithelial ovarian cancer fololwing cyto reductive surgery is influenced by stage,residual tumor,and the number of courses of chemotherapy.Combined modality therapy is the main method on treating ovarian cancer.