卵巢上皮癌术后激素补充治疗对肿瘤预后的影响

Efficacy of hormone replacement therapy after surgery on prognosis of epithelial ovarian cancer

目的探讨上皮性卵巢癌患者术后行激素补充治疗（HRT）对肿瘤预后的影响。方法连续收集北京协和医院妇产科2000年1月至2010年12月收治的〈59岁的卵巢上皮癌患者756例，术后接受HRT者79例，为病例组。随机选取同期术后未行HRT者79例为对照组。详细记录该158例患者的临床资料，对相关因素进行回顾性分析。结果．（t1）病例组术后总生存时间的中位时间45个月（术后6～264月），对照组42个月（术后6～189月），两组间差异无统计学意义（Z=0．259，P=0．796）。（2）病例组术后19例复发（24．1％），对照组24例复发（30．3％），两组间差异无统计学意义（P=0．48）。（3）病例组术后2例死亡（3％），对照组术后2例死亡（3％），两组间无差异。（4）病例组术后无进展生存时间的中位时间34个月（术后3～181月），对照组28个月（术后2～189月），log—rank分析显示：两组间的差异无统计学意义（P=0．230）。（5）多因素Cox回归分析显示，HRT不是患者术后复发的独立预后因素（P=0．129），使用HRT复发的风险率（oddsratio，OR）为0．609（95％CI=0．321～1．155），病例组死亡的OR值为0．430（95％CI=0．040-4．682）。结论卵巢上皮癌患者术后的HRT不影响疾病的总体预后。

Objective： To evaluate the efficacy of hormone replacement therapy （tlRT）after the surgery on prognosis of epithelial ovarian cancer, Methods： Seven hundred and fifty-six patients who were younger than 59 years and suffeied epithelial ovarian cancer were admitted into Peking Union Medical College Hospital from January 2000 to December 2010. Among them,79 patients who received HRT after surgerywere as treatment group, while＇79 patients who did not receive HRT after surgery were as control grup.The clinical data-of 158 patients with postoperative follow-up were reviewed retrospectively. Results; （1）The median survival interval for patients received HRT was 45 months（range, 6-264 months） while that Of patients without HRT was 42 months （range, 6-189 months）.No significant difference was found between the two groups（P=0. 796）. （2）Nineteen（24. 1 %）recurrences occurred in the treatment group and 24（30. 8%）in the control group. There was no statistical difference in the recurrence rate between the two groups（P=0.48）. （3）Two death（3 %）occurred in the treatment group and 2（3%）ifi the control group. （4）The median progression free survival interval for patients received HRT wfiS 34 months（3-181 months）versus 28 months（2-189 months）in patients without HRT. There＇ was no sigrlificartstatistical difference（P=0. 796）. （5）Multivariate Cox regression model analysis showed that HRT was not an independent prognostic factor for recurrence. Conclusions： Postoperative HRT may neither influence the disease-/ree interval nor increase the incidence of relapse, and it does not have a pronounced effect on survival of the patients with epithelial ovarian cancer.