晚期卵巢癌患者肿瘤减灭术前评估方法的进展

Progress in preoperative evaluation methods regarding cytoreduction in patients with advanced ovarian cancer

晚期卵巢癌的标准化治疗包括手术及以铂类为主的辅助化学治疗。对于部分晚期卵巢癌患者,初始手术治疗有时难以彻底切除肿瘤,实现满意的肿瘤减灭术。新辅助化学治疗可以减少肿瘤负荷,提高手术彻底切除肿瘤的可能性,作为一种补充性的治疗方法已逐渐应用于临床。对于晚期卵巢癌患者,目前有不少术前评估肿瘤减灭术的方法,比如检测血清肿瘤标志物CA125水平、影像学模型(CT,PETCT,MRI)、腹腔镜探查术等。腹腔镜探查术作为一种新的肿瘤减灭术前评估方法,值得进一步研究。

Primary cytoreductive surgery followed by platinum-based chemotherapy represents the standard treatment for patients with advanced ovarian cancer. But some patients with advanced ovarian cancer still have suboptimal residual disease after the primary debulking surgery. Neoadjuvant chemotherapy has been suggested as an alternative strategy to achieve no residual disease. It is important to find methods to estimate the likelihood that cytoreductive surgery will leave no residual disease. A number of studies have evaluated the use of serologic markers （such as CA- 125）, imaging modalities （such as CT, PETCT, MRI）, and laparoscopic surgery to determine which patients are ideal predictors for neoadjuvant chemotherapy. As a new approach of assessment for preoperative evaluation regarding cytoreduction, laparoscopic surgery deserves further research.