56例复发性卵巢癌无瘤生存期影响因素及治疗后预后分析

Analysis of the Prognosis and the Influential Factors of Disease-free Interval in 56 Patients with Recurrent Ovarian Cancer

目的：探讨复发性卵巢癌患者无瘤生存期（DFI）相关影响因素并分析两种治疗方案患者的生存预后。方法：回顾性分析56例复发性卵巢癌患者临床资料。按复发后治疗方法不同分为二次肿瘤细胞减灭术联合术后化疗22例（手术组）,单纯化疗34例（化疗组）。结果：1病理类型、组织学分级、临床分期、初次术后化疗疗程数及初次术后残余病灶大小与患者DFI有关（P〈0.05）,年龄与DFI无关（P〉0.05）;多因素分析提示临床分期、初次术后残余病灶大小是DFI独立影响因素,临床分期越早、初次术后残余病灶越小,DFI越长。2手术组较化疗组复发后中位生存时间明显延长,分别为30月与16月（χ^2=10.849,P=0.010）。复发后化疗组1、2、3、4年生存率分别为65%,32%,8%,0,手术组分别为95%,75%,29%,0;手术组复发后生存率较化疗组高,差异有统计学意义（P〈0.05）。结论：复发性卵巢癌患者DFI与病理类型、组织学分级、临床分期、初次术后化疗疗程数及初次术后残余病灶大小相关,临床分期、初次术后残余病灶大小是DFI的独立影响因素。二次肿瘤细胞减灭术联合化疗可提高患者复发后的近期生存率。

Objective：To analize the influential factors Of disease-free interval（DFI） and the prognosis of the different treatments with recurrent ovarian cancer. Methods：56 patients with recurrent ovarian cancer were re- viewed retrospectively. Patients were divided into two groups,22 patients were treated with Secondary cytoreduc- tive surgery combined with chemotherapy（Surgery group）,34 patients were treated with Salvage chemotherapy （chemotherapy group）. Results ：①pathological pattern, histological grade, clinical stage, the chemotherapy after initial cytoreductive surgery,the size of the residual tumor were associated with DFI （P 〈 0.05）, age was not as- sociated with DFI （ P 〉 0.05）. Clinical stage and the size of the residual tumor were the independent influential factors of DFI with multiple factors. Clinical stage earlier,the size of there sidual tumor smaller the DFI will be lon- ger. ②The median survival time after relapse of surgery group was 30 months,which was significantly longer than patients in chemotherapy group （ 16 month, P = 0. 010 ）. The one-year, two-year, three-year, four-year survival rates of chemotherapy group were 65%, 32%, 8%, 0% after relapse, respectively. The one-year, two-year, three-year,four-year survival rates of Surgery group were 95%,75% ,29%,0% after replase, respectively. The survival rate of Surgery group was significantly higher than chemotherapy group（ P 〈 0.05）. Conclusions.Patho- logical pattern, histological grade, clinical stage, the chemotherapy after initial cytoreductive surgery, and the size of the residual tumor are associated with DFI in recurrent ovarian cancer. The secondary cytoreductive surgery might improve the recent survival rate of patients with recurrent ovarian cancer.