Ⅳ期上皮性卵巢癌的生存率及其影响因素分析

A Study of Prognostic Factors of Stage Ⅳ Epithelial Ovarian Cancer

目的 探讨 期上皮性卵巢癌患者的生存率及其影响因素。方法 对该医院近 10年内有较细致随访资料的 31例上皮性卵巢癌进行回顾性分析。结果 1单因素分析表明 ,是否手术、化疗疗程数、肿瘤残留病灶大小、肿瘤组织学类型、转移部位以及分化程度均显著影响 期卵巢癌的生存率 (P<0 .0 5 )。2建立的 COX模型发现 ,化疗疗程数达到 8次和残留病灶≤ 2 cm两因素能分别降低死亡风险概率 0 .2 8和 0 .72 ,而未行手术、远处淋巴结转移及肝脏转移会增加死亡风险概率 ,其相对风险度分别是手术者、无远处淋巴结转移者及无肝脏转移者的14.2 5倍、11.44倍和 1.85倍。该模型预测 期上皮性卵巢癌患者的中位生存时间为 16 .8± 6 .5月。结论 应尽早采用彻底的缩瘤手术和积极、适宜的化疗等综合性治疗措施 ,以改善病人生活质量和提高生存率。

Objective To determine the effects of treatments for stage Ⅳ epidermal ovarian cancer and detect the prognostic factors. Methods 31 cases primarily treated in our hospital from 1990 to 1998 were analyzed retrospectively. Results Univariate analysis showed that the number of courses of chemotherapy, the size of residual disease, the histologic cell type, and the metastatic site were the significant prognostic factors( P< 0.05). Cox proportional hazard model confirmed that two factors(the size of residual lesion ≤2 cm and the cycles of chemotherapy ≥8 decreased the death odds ratio by 0.28 and 0.72 respectively. Three factors (lack of operation, presence of supraclavicular lymph node involvement and liver involvement) increased the death odds ratio by 14.25 times, 11.44 times and 1.85 times respectively ( P< 0.05). Conclusion Surgical debulking, aggressive and appropriate chemotherapy are important measures to improve survival rate for patients with stage Ⅳ epithelial ovarian cancer.