铂敏感复发卵巢癌手术相关问题与规范化诊疗

Problems related to surgery for platinum-sensitive relapsed ovarian cancer and standardized diagnosis and treatment

复发卵巢癌并无普遍接受的标准治疗模式,3项平行随机对照研究(SOC-1,DESKTOP 3和GOG-0123)为铂敏感复发卵巢癌二次手术提供了更高级别的循证医学证据。基于现有循证医学依据及中国的SOC-1研究结果,文章介绍了铂敏感初次复发卵巢癌新的诊疗模式:通过有效的患者选择标准筛选手术获益的最大人群,但同时警示不恰当的手术反而有害,并指明适合每个复发卵巢癌患者的治疗路径;复发卵巢癌的治疗仅仅是卵巢癌系统治疗中的一个环节、手术仅仅是复发卵巢癌治疗的手段之一,推进中国卵巢癌整体的规范化诊疗,还有很长的路要走。

The standards of care for relapsed ovarian cancer are not well determined.Given the results of three parallel randomized clinical trials(SOC-1,DESKTOP 3,and GOG-0213)on the efficacy of secondary cytoreductive surgery,patients with relapsed ovarian cancer who have received one previous therapy should be counselled about the options of secondary cytoreduction in specialized centers with high volumes of ovarian cancer surgery.An ideal patient selection algorithm should be implemented to filter right candidates.Meanwhile,an inappropriate decision on surgery could be detrimental.An individual therapy should be clearly indicated for each of patients.Secondary cytoreductive surgery is just a part of systemic therapies for ovarian cancer,and state of the art therapy for relapse comes from standard of care of the first-line therapy.In china,it’s a long way.