儿童及青少年卵巢恶性肿瘤(附74例临床分析)

Malignant ovarian tumors in children and adolescents:A clinical analysis of 74 cases

目的 探讨儿童及青少年卵巢恶性肿瘤的临床特点和治疗方法 ,以期提高患者的术后生存质量。方法 回顾分析我院 5 0年内收治的 74例年龄≤ 19岁的卵巢恶性肿瘤患者的临床资料。结果 患者平均年龄为 16 .2岁 ,无有效的早期诊断方法 ,病理类型以生殖细胞来源为主 (6 3.5 % )。临床分期 :Ⅰ期 5 9例 (79.7% ) ,Ⅱ期 7例 (9.5 % ) ,Ⅲ期 7例 (9.5 % ) ,Ⅳ期 1例 (1.4 % )。 1例于术后 11年复发 (1.4 % ) ,3、5、10年的生存率分别为 76 .9%、6 4 .0 %和 5 3.7%。Ⅰa、Ⅰb患者的 5、10年的生存率分别为 93.8%和 6 1.8%。结论 手术是主要治疗方法 ,Ⅰa期患者宜选择保守性手术 ,晚期患者宜行根治性手术。多因素分析认为 ,临床分期是影响预后的主要因素。术后辅助治疗能提高Ⅰa期生殖细胞肿瘤患者的生存率 。

Objective To study the clinical features and management of malignant ovarian tumors in children and adolescents so as to improve their quality of lives after surgery. Methods Retrospectively analyzed 74 cases of children and adolescents with malignant ovarian tumors in the past 50 years.Results The mean age of the patients was 16.2 years. Germ cell malignancies were the most common malignant ovarian tumors found in children and adolescents. Stage: Ⅰ 59(79.7%),Ⅱ 7(9.5%),Ⅲ 7(9.5%),Ⅳ 1(1.4%). 1 (1.4%) recurred after 13 years of operation, the 3,5 and 10 year survival rates were 76.9%, 64.0% and 53.7%, respectively. The 5 and 10 year survival in stage Ⅰa、Ⅰb were 93.8% and 61.8%, respectively. Conclusion Operation is the main treatment. Stage Ⅰa patients likely to be conservativly treated, while radical operation should be performed for advanced cases. Cox regression analysis shows that clinical staging is the main factor affecting the prognosis. Postoperative adjuvant therapy can improve the survival rate of stage Ⅰa germ cell tumour, but not that of epithelial malignant ovarian tumor.