非生殖道来源的卵巢转移性癌的预后影响因素

Factors influencing prognosis of extragenital metastatic cancer of ovary

目的 :观察影响非生殖道来源的卵巢转移性癌疗效的预后因素。方法 :回顾性分析我院 1980年 8月～ 1997年 12月收治的非生殖道来源的卵巢转移性癌 5 7例。根据手术方式分为 :甲组 (2 5例 )原发瘤加转移瘤切除 ;乙组 (32例 )仅转移瘤切除。两组均于术后辅以化疗。结果 :甲、乙组的中位生存期分别为 19、10个月 ,两组间中位生存期差异有显著性 (P <0 .0 1)。原发瘤为胃肠道者与非胃肠道者的中位生存期分别为 12个月与 2 7个月 (P <0 .0 1)。印戒细胞癌与非印戒细胞癌的中位生存期分别为 9个月和 2 1个月 (P <0 .0 1)。淋巴结清扫与未清扫两者的中位生存期分别为 12个月、10 .5个月 ,差异无显著性 (P >0 .0 5 )。结论 :非生殖道来源的卵巢转移性癌预后极差 ,但原发瘤切除加转移瘤切除并辅以术后化疗可以改善预后。原发瘤为胃肠道者及印戒细胞癌者预后差。卵巢转移性癌做淋巴结清扫术临床意义不大。

Objective:To investigate the prognostic factors of the patients with extragenital metastatic ovary cancer.Methods:A retrospective analysis of 57 patients with extragenital metastatic ovarian cancer from Aug.1980 to Dec.1997 in our hospital was done.Those patients were categorized into two groups in accordance with the treatment received.Fifteen patients in group A received resection of the primary tumor and metastasectomy.Thirty two patients in group B received only metastasectomy.All patients in two groups received postoperative chemotherapy.Results:The median survival time in group A is 19 months while group B is only 10 months.The difference is significant( P <0.01).The median survival time in patients whose primary tumor is of gastrointestinal origin or not is 12 and 27 months( P <0.01),respectively.The median survival time in patients with cancer signet ring cell type or not is 9 and 21 months( P <0.01) respectively.The median survival time in patients who received lymphadenectomy or not is 12 and 10.5 months( P >0.05)respectively.Conclusions:The prognosis of patients with extragenital metastatic ovarien cancer is extremely poor,but resection of primary tumor and metastasectomy plus postoperative chemotherapy makes the prognosis better.The prognosis of patients with primary tumor of gastrointestinal origin,and belongs to signet cell type is poor.Lymphadenectomy in extragenital metastatic ovarian cancer is not significant.