Role of Secondary Cytoreductive Surgery in Ovarian Cancer Relapse: Who Will Benefit? A Systematic Analysis of 240 Consecutive Patients
Role of Secondary Cytoreductive Surgery in Ovarian Cancer Relapse: Who Will Benefit? A Systematic Analysis of 240 Consecutive Patients
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DOI：
10.1002/jso.21652
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发表时间：
2010-11-01
影响因子：
2.5
通讯作者：
Fotopoulou, Christina
中科院分区：
文献类型：
--
作者：
Sehouli, Jalid;Richter, R.;Fotopoulou, Christina
背景和目的：与原发性卵巢癌相比，手术治疗复发性卵巢癌（ROC）的价值尚不清楚。我们评估了ROC中继发性细胞减少的手术和临床结果。方法：所有接受继发性肿瘤缩小手术的连续ROC患者均根据经验证的术中记录工具肿瘤传播模式进行系统分析。采用cox -回归分析确定死亡率的独立预测因素。结果：在2000年9月至2008年10月期间，评估了240例手术。184例（81%）为铂敏感，43例（20%）为铂耐药，47.5%的患者出现腹水。85.8%的患者出现多灶性肿瘤播散，53.8%的患者肿瘤完全切除。还有24.2%。术后肿瘤残留500 ml （HR 6 76）。95% Cl. 3 77-12 1).铂电阻（HR 31）。95% Cl 1 26-7 7)和初始FIGO IV期（HR 2 86）。肿瘤完全切除患者的中位生存期分别为423个月（95% CI为24 37 ~ 60 2）、17个月（95% CI为12 27 ~ 23 13）和7个月（95% CI为31 ~ 12 3），肿瘤残差为1 cm
Background and Objectives: In contrast to primary ovarian cancer, the value of surgery in relapsed-OC (ROC) remains unclear We evaluated surgical and clinical outcome of secondary cytoreduction in ROCMethods: All consecutive ROC patients who underwent secondary tumor-debulking surgery were systematically analyzed as based on a validated intraoperative documentation tool Tumor dissemination pattern. operative and clinical outcome were evaluated Cox-regression analysis was performed to identify independent predictors of mortalityResults: Between 09/2000 and 10/2008, 240 operations were evaluated. 184 patients (81 1%) were platinum-sensitive and 43 (20%) platinum-resistant 47 5% of the patients had ascites. while 85 8% presented a multi focal tumor dissemination pattern In 53 8% a complete tumor resection was achieved. in another 24 2%. postoperative tumor residuals were 500 ml (HR 6 76. 95% Cl. 3 77-12 1). platinum resistance (HR 3 1. 95% Cl 1 26-7 7). and initial FIGO stage IV (HR 2 86. 95% CI I 16-7) were the most significant risk factors for mortality Median OS was 42 3 months (95% CI 24 37-60 2). 17 7 months (95% CI 12 27-23 13), and 7 7 months (95% CI 3 1-12 3) for patients with complete tumor resection, tumor residuals 1 cm. respectively (trend P-value