论文部分内容阅读
目的探讨晚期卵巢上皮癌的综合治疗因素对预后的影响。材料与方法回顾性分析１９８３～１９９２年治疗的２２４例晚期卵巢癌的术后残存肿瘤大小、术前化疗、术后顺铂联合化疗疗程、二次剖腹探查结果、复发病人的再次减瘤术及放疗等治疗因素与预后的关系。结果全组３年和５年生存率各为２９％和１５％。Ⅲ期术后残存肿瘤≤２ｃｍ与＞２ｃｍ的３年和５年生存率各为５０％、２０％和３０％、５％，Ｐ值均＜０．０１。术后化疗≥６与＜６疗程的３年和５年生存率分别为５２％、１４％和２５％、８％，Ｐ值均＜０．０１。８９例术前化疗有效和无效对预后无影响（Ｐ＞０．０５），但在有效者中术后残存肿瘤≤２ｃｍ与＞２ｃｍ影响５年生存率，各为２３％与０（Ｐ＜０．０５）。５５例复发病人再次减瘤术后残存肿瘤≤２ｃｍ与＞２ｃｍ的３年和５年生存率各为４３％、４％和３２％、０，Ｐ值均＜０．００１。结论Ⅲ期和术前化疗有效与复发病人术后达理想减瘤术者、顺铂联合化疗≥６疗程可获长期生存益处。
Objective To investigate the effect of comprehensive treatment factors on the prognosis of advanced epithelial ovarian cancer. Materials and Methods Retrospective analysis of the residual tumor size of 224 cases of advanced ovarian cancer treated from 1983 to 1992, preoperative chemotherapy, postoperative cisplatin combined chemotherapy, secondary exploratory laparotomy, and recurrent tumor reduction Therapeutic factors such as radiotherapy and prognosis. Results The overall 3-year and 5-year survival rates for the whole group were 29% and 15%. The three-year and five-year survival rates of residual tumors ≤2cm and >2cm after stage III were 50%, 20%, 30%, and 5%, respectively. P values were <0.01. The 3-year and 5-year survival rates of postoperative chemotherapy ≥6 and <6 courses were 52%, 14%, 25%, and 8%, respectively. P values were <0.01. 89 cases of preoperative chemotherapy were effective and ineffective. Influencing (P>0.05), but residual tumors ≤2 cm and >2 cm in effective patients affected 5-year survival rates, with 23% and 0 respectively (P<0.05). The 3-year and 5-year survival rates of residual tumors ≤2cm and >2cm after resection of tumors in 55 patients with relapses were 43%, 4%, and 32%, respectively, and the P values were all < 0.001. Conclusions Long-term survival benefit can be achieved with effective treatment of stage III and preoperative chemotherapy and recurrence of patients with ideal cytoreductive surgery and cisplatin ≥6 cycles of chemotherapy.