SALVAGE SURGERY FOR CHEMOREFRACTORY OVARIAN GERM-CELL TUMORS
SALVAGE SURGERY FOR CHEMOREFRACTORY OVARIAN GERM-CELL TUMORS
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DOI：
10.1006/gyno.1994.1280
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发表时间：
1994-11-01
影响因子：
4.7
通讯作者：
BURKE, TW
中科院分区：
文献类型：
--
作者：
MUNKARAH, A;GERSHENSON, DM;BURKE, TW
本研究旨在确定二次手术减积是否对恶性卵巢生殖细胞肿瘤（OGCT）患者有益。回顾性分析了1975年至1992年间在我院治疗的20例OGCT患者。使用Kaplan和Meier的寿命表方法分析生存率，并通过对数秩和Wilcoxon检验检验各种围手术期因素的统计学意义。组织学类型包括未成熟畸胎瘤8例，混合瘤6例，内胚窦瘤5例，无性细胞瘤1例。初次手术后，所有患者均接受化疗-12例患者接受非铂类药物治疗，5例患者接受铂类药物治疗，3例患者接受两种类型的化疗。治疗失败分类为14例患者进展，3例持续存在，3例复发。挽救性手术包括剖腹探查和肿瘤减灭术18例，腹股沟淋巴结清扫术1例，开胸楔形切除术1例。16例患者随后接受了挽救化疗。在分析时，11例患者无病存活，1例患者有肿瘤存活，6例死于特纳进展，2例死于治疗相关并发症。未成熟畸胎瘤患者接受挽救性手术的生存率明显优于其他肿瘤细胞类型的生存率（P = 0.006）。总之，虽然二次减瘤在化疗难治性OGCT中的作用尚未确定，但它可能对一组选定的患者，特别是未成熟畸胎瘤患者有一定的益处。(C)1994年出版社出版。
This study was undertaken to determine whether secondary surgical debulking is beneficial for patients with malignant ovarian germ cell tumors (OGCT). Twenty patients with OGCT treated at our institution between 1975 and 1992 were retrospectively identified and analyzed. Survival was analyzed using the life-table methods of Kaplan and Meier and the statistical significance of various perioperative factors was tested by both the log-rank and the Wilcoxon tests. Histologic tumor type included 8 immature teratomas, 6 mixed tumors, 5 endodermal sinus tumors, and 1 dysgerminoma. After primary surgery, all patients received chemotherapy-non-platinum-based in 12 patients, platinum-based in 5, and both types in 3 patients. Treatment failure was classified as progression in 14 patients, persistence in 3, and recurrence in 3. Salvage surgery consisted of exploratory laparotomy and tumor debulking in 18 patients, inguinal lymphadenectomy in 1, and thoracotomy and wedge resection in 1. Sixteen patients subsequently received salvage chemotherapy. At the time of analysis, 11 patients were alive disease-free, 1 was alive with tumor, 6 had died of turner progression, and 2 had died of treatment-related complications. Survival of patients with immature teratoma who underwent salvage surgery was significantly better than survival of those with other tumor cell types (P = 0.006). In conclusion, although the role of secondary debulking in chemorefractory OGCT remains undetermined, it may have some benefit for a select group of patients, particularly those with immature teratoma. (C) 1994 Academic Press, Inc.