The clinical significance of hepatic parenchymal metastasis in patients with primary epithelial ovarian cancer
The clinical significance of hepatic parenchymal metastasis in patients with primary epithelial ovarian cancer
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DOI：
10.1016/j.ygyno.2008.09.046
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发表时间：
2009-01-01
影响因子：
4.7
通讯作者：
Park, Sang-Yoon
中科院分区：
文献类型：
--
作者：
Lim, Myong Cheol;Kang, Sokbom;Park, Sang-Yoon
Objective.本研究的目的是确定肝实质转移对晚期上皮性卵巢癌患者生存的临床意义。我们对2001年1月至2008年1月在韩国国家癌症中心接受治疗的IIIc期和IV期卵巢癌肝实质转移患者进行了回顾性分析。肝转移瘤分为不能切除的血行转移和可切除的腹膜种植转移。确定了120例患者，其中113例纳入研究。IIIc期组包括97例患者，IV期疾病和肝实质转移组包括16例患者。在16例肝实质转移患者中，2例患者存在不可切除的血源性肝实质转移，与来自腹膜种植的可切除肝实质转移患者相比，预后较差。14例腹膜种植肝实质转移患者接受了完整切除术，无并发症，包括：楔形切除术（n = 7），肝段切除术（n = 5）和半肝切除术（n = 2）。年龄、肿瘤分级、组织学、血清CA-125水平和最佳减积率在患有可切除的腹膜种植肝实质转移的Me期疾病患者和IV期疾病患者中相似。分期疾病患者的5年无进展生存率和5年总生存率分别为25%和23%（p = 0.8063），IV期疾病患者的5年无进展生存率和5年总生存率分别为55%和51%（p = 0.5671）。我们的研究结果提示，对于腹膜种植引起的肝实质转移的患者，应尝试完全肝切除。(c)2008年爱思唯尔公司All rights reserved.
Objective. The objective of this study was to determine the clinical significance of hepatic parenchymal metastasis on survival in patients with advanced epithelial ovarian cancer.Methods. We conducted a retrospective review of ovarian cancer patients with stages IIIc and IV hepatic parenchymal metastasis who were treated at the National Cancer Center in Korea between January 2001 and January 2008. Hepatic metastases were divided into unresectable, hematogenous parenchymal metastasis and resectable, parenchymal metastasis from peritoneal seeding.Results. One hundred twenty patients were identified, 113 of whom were included in the study. The stage IIIc group included 97 patients, and the group with stage IV disease and hepatic parenchymal metastasis included 16 patients. Of the 16 patients with hepatic parenchymal metastasis, 2 patients had unresectable, hematogenous parenchymal metastasis with a poor prognosis compared to the patients with resectable, hepatic parenchymal metastasis from peritoneal seeding. Fourteen patients with hepatic parenchymal metastases from peritoneal seeding underwent complete resection without complications as follows: wedge resection (n = 7), segmentectomy (n = 5), and hemi-hepatectomy (n = 2). Age, tumor grade, histology, serum CA-125 level, and the rate of optimal debulking were similar in patients with stage Me disease and patients with stage IV disease who had resectable, hepatic parenchymal metastasis from peritoneal seeding. The 5-year progression free survival rate and the 5-year overall survival rate for patients with stage life disease and patients with stage IV disease and hepatic parenchymal metastasis from peritoneal seeding were 25 and 23% (p = 0.8063), and 55 and 51% (p = 0.5671), respectively.Conclusion. Our findings suggest that complete hepatic resection should be attempted for patients with hepatic parenchymal metastasis from peritoneal seeding. (c) 2008 Elsevier Inc. All rights reserved.