卵巢癌治疗后早期复发因素的探讨

Early Recurrent Factors of Ovarian Cancer after Treatment

背景与目的:卵巢癌易复发,目前对其尚无令人满意的有效治疗方法。本文旨在探讨卵巢癌治疗后早期复发的因素,以降低其复发率。方法:回顾性分析1986年1月至1996年5月在我院住院治疗后1年内复发的卵巢癌患者的临床资料,分别比较其不同的临床分期、病理类型、残瘤灶大小、化疗情况的复发率。统计学分析用X^2检验。结果:373例卵巢癌治疗后1年内复发者82例,复发率为22.0％。Ⅰ～Ⅱ期患者的1年内复发率低于Ⅲ～Ⅳ期患者(2.7％ vs.30.3％,P<0.01);未分化腺癌患者的复发率高于其它类型患者;残留灶≥2 cm者的复发率高于<2 cm者(33.8％ vs.13.7％,P<0.01)。术前化疗者的1年内复发率低于术前未化疗者(11.0％ vs.30.5％,P<0.01);术后化疗1～3疗程者复发率高于4～6疗程及>6疗程者(67.0％ vs.7.7％,67.0％ vs.7.0％,P<0.01)。结论:卵巢癌治疗后1年内复发大多与临床期别较晚、手术切除不彻底和化疗疗程不足有关。

BACKGROUND & OBJECTIVE: Recurrence of ovarian cancer is an important factor that leads to therapeutic failure. At present, the treatment in ovarian cancer is not sufficiently effective. This study was designed to investigate the factors of early recurrence after treatment in ovarian cancer in order to reduce its recurrence. METHODS: The clinical data of the ovarian cancer patients admitted to Affiliated Hospital of Guangxi Medical University during January 1986 to May 1996 who recurred within one year after treatment were analyzed retrospectively. The recurrent rates were compared according to their different clinical stages, pathological types, and residual volumes of the disease as well as the number of courses of pre and postoperative chemotherapy received. Chi-square test was used for statistic analysis. RESULTS: Eighty-two of 373 cases recurred within one year after treatment; the overall recurrent rate was 22. 0%. The 1-year recurrent rate in stage I - II patients was lower than that in stage III - IV patients (2. 7% versus 30. 3%, P < 0. 01). The recurrent rate in the patients with undifferentiated adenocarcinoma was higher than that with other pathological type. The recurrent rate in the patients with residuals 5=2 cm was higher than that with residuals <2 cm (33. 8% versus 13. 7%, P <0. 01). The recurrent rate in the patients with preoperative chemotherapy was lower than that without it. The recurrent rate in the patients who had received only 1 -3 courses of postoperative chemotherapy was higher than that having received 4 -6 or > 6 courses (67. 0% versus 7. 7%, 67. 0% versus 7. 0% , respectively, P < 0. 01). CONCLUSION: Early (1-year) recurrence in the patients with ovarian cancer seems to be closely related to late stage of the disease, incomplete surgery, and insufficient chemotherapy courses.