Long-term results of cytoreductive surgery for advanced and recurrent epithelial ovarian cancers and papillary serous carcinoma of the peritoneum
Long-term results of cytoreductive surgery for advanced and recurrent epithelial ovarian cancers and papillary serous carcinoma of the peritoneum
复制标题
细胞减灭术治疗晚期和复发性上皮性卵巢癌和腹膜乳头状浆液性癌的长期结果
DOI：
10.1136/ijgc-00009577-200401000-00004
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
P. Sugarbaker
中科院分区：
文献类型：
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作者：
M. Look;D. Chang;P. Sugarbaker
本研究的目的是回顾肿瘤细胞减灭术治疗晚期原发性和复发性上皮性卵巢癌和腹膜乳头状浆液性癌的长期结果。我们的目标是确定临床因素，通过这些因素选择可能从综合管理计划中受益的患者。从前瞻性数据库中检索了28例接受手术的女性的临床数据。25例患者可能进行主要的细胞减灭术。在适当的情况下，还使用了术中或术后早期腹腔内加热化疗。细胞减灭术后的中位随访时间为26.9个月。细胞减灭术后的总中位生存期为45.8个月。对生存率有统计学显著影响的预后指标为术前评分（P < 0.001）、细胞减灭完整性评分（CC; P = 0.037）和术前化疗反应（P = 0.012）。我们的研究结果表明，肿瘤细胞减灭术结合围手术期腹腔化疗是有效的。通过排除CC似乎不太可能的病例可以改善结果。既往广泛手术且无连续性腹腔化疗保护者预后不良。这可能是由于解剖平面的破坏导致腹部和盆腔深部播散，难以进一步治疗。
The aim of this study was to review the long-term results of cytoreductive surgery in the treatment of advanced primary and recurrent epithelial ovarian cancers and papillary serous carcinoma of the peritoneum. Our goal was to identify clinical factors by which to select patients likely to benefit from a comprehensive management plan. Clinical data of 28 females who underwent surgery were retrieved from a prospective database. Major cytoreductive procedures were possible in 25 patients. Heated intraoperative or early postoperative intraperitoneal chemotherapy was also used where appropriate. The median follow-up after cytoreduction was 26.9 months. The overall median survival after cytoreduction was 45.8 months. The prognostic indicators associated with a statistically significant impact on survival were the prior surgery score (P < 0.001), the completeness of cytoreduction score (CC; P = 0.037), and response to chemotherapy prior to surgery (P = 0.012). Our findings suggest that cytoreductive surgery can be effective when combined with perioperative intraperitoneal chemotherapy. Results can be improved by excluding cases where CC seems unlikely. Extensive prior surgery without the protection of adjunctive intraperitoneal chemotherapy is associated with a poor prognosis. This may be due to disruption of anatomical planes leading to deep abdominal and pelvic dissemination intractable to further treatment.