恶性卵巢生殖细胞肿瘤64例临床分析

Clinical analysis of 64 cases of malignant ovarian germ cell tumor

目的对恶性卵巢生殖细胞肿瘤患者进行临床分析,探讨治疗方法,评估治疗效果。方法回顾性分析2009年1月至2019年12月中国科学技术大学附属第一医院妇产科收治的64例恶性卵巢生殖细胞肿瘤患者的病历资料及随访情况,包括病理类型、年龄分布以及国际妇产科联盟(FIGO)分期、治疗、随访结果等资料。结果56例接受保留生育功能的手术,8例采用根治性手术。64例患者中54例进行了术后化疗。术后辅助化疗采用PVB(顺铂+长春新碱+博莱霉素)方案、PEB(顺铂+依托泊苷+博莱霉素)方案。其中47例采用PEB方案化疗,7例采用PVB方案化疗。20例患者失访,3例复发,复发者1例死亡,存活43例。40例保留生育功能,23例术后有妊娠史,其中19例已生育,余17例未婚。结论恶性卵巢生殖细胞肿瘤早期患者保留生育功能的治疗是行之有效的方法,对无生育要求及晚期患者行根治性手术是必要的。规范的术后化疗对提高生存率及生活质量具有重要作用。

Objective To evaluate the therapeutic effects of patients with malignant ovarian germ cell tumors.Methods The clinical data of 64 patients with malignant ovarian germ cell tumors admitted to the Department of Obstetrics and Gynecology,the First Affiliated Hospital of University of Science and Technology of China from January 2009 to December 2019,including pathological type,age distribution,FIGO stage,treatment,follow-up were analyzed retrospectively.Results Fertility was preserved in 56 patients and 8 patients received radical surgery.Among the 64 cases,54 patients received postoperative adjuvant chemotherapychemotherapy which mainly included PVB(cisplatin+vincristine+bleomycin)or PEB(cisplatin+etoposide+bleomycin)regimen.Of these,47 patients received chemotherapy with PEB and 7 patients received chemotherapy with PVB.Unfortunately,20 patients were lost to follow-up,3 relapsed and 1 died.Among 43 survived cases,40 retained fertility,in which 23 had a history of pregnancy And 19 of them had already given birth and the remaining 17 were unmarried.Conclusions The treatment of fertility preservation is an effective method for patients in the early stage,the radical surgery is also necessary for patients with no fertility requirements and advanced stages.Standardized chemotherapy plays an important role in improving survival and quality of life.