Routine appendectomy in epithelial ovarian carcinoma: Is it necessary?
Routine appendectomy in epithelial ovarian carcinoma: Is it necessary?
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DOI：
10.1097/01.aog.0000154884.20872.c4
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发表时间：
2005-04-01
影响因子：
7.2
通讯作者：
Kucukali, T
中科院分区：
文献类型：
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作者：
Ayhan, A;Gultekin, M;Kucukali, T
目的：检测阑尾转移的危险因素，并确定常规阑尾切除术在上皮性卵巢癌患者中的作用。方法：回顾性评估了总计285例接受初次细胞减灭术（包括阑尾切除术）的上皮性卵巢癌患者。阑尾受累分为2组：肉眼和显微镜。临床病理学变量进行了评估，可能的意义，在阑尾转移。使用相同的变量进行第二次分析，以检测与显微镜下转移的可能关系。在亚组分析中，我们还分析了常规阑尾切除术在临床早期疾病患者中的作用。结果：106例患者发现有阑尾转移（37%）。单因素和多因素分析显示，疾病分期是决定阑尾转移的唯一因素（P <0.001）。5例明显为I-II期的患者因孤立性阑尾转移而分期升高（4.9%）。在第二次分析中，排除了肉眼受累的患者，腹水是镜下受累的独立预测因子（P <0.01）。结论：常规阑尾切除术适用于所有上皮性卵巢癌患者，作为初始手术分期程序的一部分，因为早期疾病有相当高的分期提高率，晚期肿瘤细胞减少率最佳。
OBJECTIVE: To detect risk factors for the appendiceal metastasis and to define the role of routine appendectomy in patients with epithelial ovarian carcinoma.METHODS: A total of 285 patients with epithelial ovarian carcinoma who had undergone primary cytoreductive surgery including appendectomy were retrospectively evaluated. Appendiceal involvement was divided into 2 groups: gross and microscopic. Clinicopathologic variables were evaluated for possible significance in terms of appendiceal metastasis. A second analysis was performed using the same variables to detect a possible relation with microscopic metastasis. In a subgroup analysis, we also analyzed the role of routine appendectomy in patients with clinically early stage disease.RESULTS: One-hundred six patients were found to have appendiceal metastasis (37%). Univariate and multivariate analysis revealed stage of disease as the unique factor determining the appendiceal metastasis (P < .001). Five patients with apparently stage I-II disease were upstaged due to isolated appendiceal metastasis (4.9%). In the second analysis excluding the patients with gross involvement, ascites was an independent predictor of microscopic involvement (P < .01).CONCLUSION: Routine appendectomy is indicated in all epithelial ovarian carcinoma patients as part of the initial surgical staging procedure because of a considerable rate of upstaging in early stage disease and optimal cytoreduction in advanced stages.