Prognosis of patients who relapse after fertility-sparing surgery in epithelial ovarian cancer
Prognosis of patients who relapse after fertility-sparing surgery in epithelial ovarian cancer
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DOI：
10.1245/s10434-007-9651-x
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发表时间：
2008-02-01
影响因子：
3.7
通讯作者：
Morice, Philippe
中科院分区：
文献类型：
--
作者：
Marpeau, Olivier;Schilder, Jeanne;Morice, Philippe
背景：上皮性卵巢癌（EOC）保留生育能力手术后复发的患者的预后仍不清楚。这是第一项评估这种情况下复发患者生存率的研究。方法：对文献中报道的 EOC 保留生育功能手术的四个主要系列中复发患者的结果进行了审查和更新（如果可行）。结果：该系列中的 166 名患者中有 23 名报告患有复发性疾病。 17 名患者的复发部位为腹膜（+/- 剩余卵巢），6 名患者的复发部位为远处。 12 名患者死于复发性疾病，2 名患者因持续性疾病仍活着，8 名患者已无病，1 名患者还活着，但具体状况未知。在剩余卵巢出现孤立性复发的 8 例患者 (34%) 中，2 例死亡，1 例失访。结论：在这个经过仔细监测（包括系统放射学检查）的人群中，幸存卵巢的孤立性复发率较低。这些患者的复发预后较差。这些结果表明，应仔细确定保留生育手术候选者的初始选择，以降低预后不良的复发率。
Background: The prognosis for patients who develop a recurrence after fertility-sparing surgery for epithelial ovarian cancer (EOC) remains unclear. This is the first study to evaluate survival in patients who have developed a recurrence in this context.Methods: The outcomes of relapsed patients reported in the literature in the four main series of fertility-sparing surgery for EOC were reviewed and updated (where feasible).Results: Twenty-three of the 166 patients in the series were reported to have recurrent disease. The site of the recurrence was the peritoneum (+/- remaining ovary) in 17 patients, and distant in six patients. Twelve patients died of recurrent disease, two are still alive with persistent disease, eight are disease-free, and one is alive but her exact status is not known. Among eight patients (34%) with an isolated recurrence on the remaining ovary, two died and one was lost to follow-up.Conclusion: In this carefully monitored population, including systematic radiological examinations, the rate of isolated recurrences on the spared ovary is low. Recurrence in these patients carries a poor prognosis. Such results suggest that initial selection of candidates for fertility-sparing surgery should be carefully defined to reduce the rate of recurrences that carry a poor prognosis.