摘要
目的 探讨上皮性卵巢癌复发的特征及相关临床因素。方法 回顾性分析 1 994年～ 2 0 0 2年 8年在北京大学第一医院妇科收治的 1 71例上皮性卵巢癌的临床病理资料 ,对其中 6 1例复发病例进行比较。结果1 71例上皮性卵巢癌中 ,6 1例复发 ,总复发率 35 7%。有乳腺癌及其他妇科恶性肿瘤合并症的患者复发率为4 5 5 % ,有妇科恶性肿瘤家族史的患者复发率为 1 0 0 % ;Ⅰ、Ⅱ期复发率 1 5 2 % ,Ⅲ、Ⅳ期复发率 4 8 5 % (P <0 0 5 ) ;低分化者复发率 4 7 2 % ,中高分化者复发率 2 1 1 % (P <0 0 5 ) ;行肿瘤细胞减灭术者 ,在残留灶 >2cm者 2 2例中 ,2 2例全部复发 ,复发率 5 4 5 % ,残留灶≤ 2cm或肉眼无残留者复发率 32 9% (P <0 0 5 ) ;合并盆腔淋巴结剔除术者复发率为 36 6 % ,未行淋巴结剔除术者复发率为 39 7% (P >0 0 5 ) ;完成化疗计划者复发率2 9 6 % ,未完成化疗计划者复发率 4 9 1 % (P <0 0 5 )。肿瘤复发与年龄、孕产次、避孕方式、病理类型、腹水情况、原发灶的部位等均无关。 6 1例复发患者中行二次肿瘤细胞减灭术结合化疗等综合治疗者占 39 3% ,复发后平均存活时间较未行二次肿瘤细胞减灭术者明显延长 (P <0 0 5 )。结论 上皮性卵巢癌的复发多在治疗后 3年之内 ,最常见的复发转移?
Objective To analyze the possible factors influencing the recurrence of epithelial ovarian carcinoma and the therapies. Methods The clinic-pathological features of 171 patients with epithelial ovarian carcinoma, admitted during 1994 and 2002, were analyzed retrospectively. Among them, 61 cases with recurrence were compared with non-recurrence. Results Sixty-one out of the 171 ovarian carcinoma recurred(35 7%). The recurrent rate of cases complicated with breast cancer or other gynecological cancer was 45 5%, while with the familial history of gynecological malignant tumour was 100%. The recurrent rate of poor differentiated cancer was 47 2%,which was significantly higher than that of 21 1% in middle or well differentiated ( P < 0 05). According to the FIGO criteria (1988) the recurrent rate of stageⅠ, Ⅱ (15 2%) was significantly lower than that of stage Ⅲ, Ⅳ(48 5%)( P < 0 05). In cases with >2cm residual lesion, the recurrent rate (54 5%) was significantly higher than those with ≤2cm residual lesion (32 9%) ( P <0 05). The recurrent rate was lower in the patients treated with the completely chemotherapy (29 6%) than without(49 1%)( P < 0 05). The recurrence had no relationships with the pregnancy, delivery histories, pathologic type, peritoneal cytology and whether undergone the lymphadenectomy. There was 39 3% recurrent cases underwent the compositive therapy including the second cytoreductive surgery, and their survival time was longer than that without the second cytoreductive surgery ( P < 0 05). Conclusions Epithelial ovarian carcinoma relapse mostly within 3 years after initiative therapy. The most common recurrent sites are pelvic and peritoneal cavity and lung. Certain relationship is found between the recurrence and complication of breast cancer or other gynecological cancer, family history of gynecological malignant tumor, clinical stage, histological differentiation, postoperative residual volume and sufficient courses of regular chemotherapy. The compositive therapy including the second cytoreductive surgery should be conducted for the recurrent cases.
出处
《中国妇产科临床杂志》
2004年第3期180-184,共5页
Chinese Journal of Clinical Obstetrics and Gynecology
