晚期卵巢上皮性癌的治疗及其对预后的影响

Treatment and prognostic factors for advanced epithelial ovarian cancer..

目的:探讨晚期卵巢上皮性癌的治疗及其对预后的影响。方法:回顾分析晚期卵巢上皮性癌患者76例的临床资料,生命统计采用Kaplan-Meier法及Log-rank法检验,利用COX风险比例回归模型判断患者独立的预后影响因素并进行分析。结果:分期、残余灶、腹膜后淋巴结清除术及术后化疗的疗程数是影响预后的重要因素。行和未行腹膜后淋巴结清除术,总的5年存活率分别是52％和22％(P<0.01)。其中残余灶≤2cm者,行与未行腹膜后淋巴结清除术的5年存活率分别是65％、30％(P<0.01)。残余灶>2cm者,行与未行腹膜后淋巴结清除术的5年存活率分别是21％、9％,但差异没有显著性(P>0.05)。结论:理想的肿瘤细胞减灭术、腹膜后淋巴结清除术及术后至少6个疗程的化疗是改善患者预后的重要措施,但如残余灶>2cm,则不必行腹膜后淋巴结清除术。

Objective:To investigate the prognostic significance of therapeatic factors for advanced epfithelial ovarian cancer. Methods: The data of 76 patients was analyzed retrospectively. Survival was calculated by Kaplan-Meier method and comparison was performed using Log-rank test. Independent prognostic factors were identified by the COX proportional hazards regression model. Results: The stage, the volume of residual tumor, retroperitoneal lymphadenectomy and the number of courses of chemotherapy were independent prognostic factors. The overall 5-year survival rate was 5 2 % and 2 2 % for patients who did and did not undergo lymphadenectomy , respectively ( P < 0.01) .Among patients whose residual tumor <2cm, 5-year survival rate was 65% and 30% for patients who did and did not undergo lymphadenectomy, respectively ( P<0. 01) . Among patients whose residual tumor > 2cm,5-year survival rate was 21% and 9% for patients who did and did not undergo lymphadenectomy, respectively. However .there was not a significant difference between the two groups ( P>0.05). Conclusions: Optimal cytoreductive, retroperitoneal lymphadenectomy and equal or more than six cycles chemotherapy postoperatively are important measures for the better prognosis of advanced epithelial ovarian cancer. Retroperitoneal lymphadenectomy would not be performed if the residual disease were larger than 2cm.