术前化疗对晚期卵巢癌预后的影响

Evaluation of the value of chemotherapy before operation in the management of advanced epithelial ovarian cancer

目的 探讨术前化疗对晚期卵巢癌预后的影响。方法 将曾行肿瘤细胞减灭术的晚期上皮性卵巢癌患者按照术前是否化疗分为两组,进行回顾性分析,比较两组患者与预后有关的指标及生存情况。结果 1990年1月至1998年12月,收治Ⅲc期、Ⅳ期上皮性卵巢癌患者,并施行了肿瘤细胞减灭术者共71例。其中术前化疗组26例,术前未化疗组45例。两组患者手术范围基本相同。术前化疗组期别晚、分级高,预后不良的组织病理类型所占比例高,但治疗结果两组间达到满意肿瘤细胞减灭术的比例无明显差别。追踪随访术前化疗组及未化疗组,5年存活率分别为30.72％及40.60％(P>0.05)。结论 对术前估计难以达到满意的肿瘤细胞减灭术的晚期卵巢癌患者,术前化疗有可能提高生存率。

Objective To evaluate chemotherapy before operation in the management of advanced epithelial ovarian cancer. Methods The patients who had cytoreductive surgery were divided into two groups according to whether they had received chemotherapy or not before operation. Retrospective analysis was performed, while the prognostic factors and survival rates were compared. Results From Jan 1990 to Dec 1998,71 cases of epithelial ovarian cancer in stage Ⅲc and stage Ⅳ were admitted and all of them were treated by cytoreductive surgery in our hospital. Of these patients,26 cases received chemotherapy before operation, while the other 45 cases did not. The operation scale was nearly the same. Comparison of prognostic factors between the two groups showed that more patients with stage IV disease, higher cytological grade and poor aggressive histological type were in the group with chemotherapy before operation . However the rates of optimal cytoreductive surgery were similar. Five year survival rates of the two groups were 30. 72% and 40. 60% , respectively ( P > 0. 05 ). Conclusion Patients who can not initially be cytoreduced to an optimal state should be considered candidates for chemotherapy before operation , which might provide better survivals in advanced ovarian carcinoma.