LONG-TERM SURVIVAL IN ADVANCED OVARIAN-CANCER AFTER CYTOREDUCTION AND CHEMOTHERAPY TREATMENT
LONG-TERM SURVIVAL IN ADVANCED OVARIAN-CANCER AFTER CYTOREDUCTION AND CHEMOTHERAPY TREATMENT
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DOI：
10.1006/gyno.1994.1082
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发表时间：
1994-04-01
影响因子：
4.7
通讯作者：
ZANON, V
中科院分区：
文献类型：
--
作者：
DELCAMPO, JM;FELIP, E;ZANON, V
91例未经治疗的III期和IV期上皮性卵巢癌患者根据治疗方案进行治疗，包括尽可能进行细胞减灭术，CAP（环磷酰胺，多柔比星和顺铂）化疗，并对达到临床缓解的患者进行二次剖腹探查。66例患者（72.5%）未进行最佳肿瘤减灭术（残留肿瘤< 2 cm）。阴性二次剖腹探查显示26例患者（28.5%）病理完全缓解。中位随访80个月后，无病生存率为19.7%（91例患者中有18例）。最佳肿瘤细胞减灭术患者的中位生存期（47个月）高于其余患者（22个月）（P = 0.0000）。病理完全缓解患者的生存期（46个月）也优于部分缓解（PR）或无应答患者（22个月）（P = 0.0001）。（11例化疗后PR患者可能进行最佳二次细胞减灭术。本组生存率与病理完全缓解组相似。目前，53%的初始残留肿瘤< 2 cm且在二次检查时完全缓解的患者仍然没有疾病。在多变量分析中，残留肿瘤> 2 cm和IV期疾病是最重要的预后因素。同样的分析表明，在第二次剖腹手术化疗的反应不是一个独立的预后因素。总之，我们的研究表明，在晚期卵巢癌的两个最重要的预后因素是首次手术的范围和阶段。(C)1994年出版社出版。
Ninety-one patients with untreated epithelial ovarian cancer, stages III and IV, were treated according to a therapeutic protocol including cytoreductive surgery whenever possible, chemotherapy with CAP (cyclophosphamide, doxorubicin, and cisplatin) and second-look laparotomy for those patients achieving a clinical remission. Optimal cytoreductive surgery (residual tumor < 2 cm) was not performed in 66 patients (72.5%). A negative second-look laparotomy demonstrated a pathological complete remission in 26 patients (28.5%). After a median follow-up of 80 months, the disease-free survival is 19.7% (18 of 91 patients). Median survival was greater in optimal cytoreductive surgery patients (47 months) than in the rest of the patients (22 months) (P = 0.0000). Survival was also better in pathological complete remission patients (46 months) than in partial remission PR) or no response patients (22 months) (P = 0.0001). (Optimal secondary cytoreductive surgery was possible in 11 patients in PR after chemotherapy. Survival in this group was similar to that of pathological complete remission cases. Currently, 53% of patients with initial residual tumor < 2 cm and complete response at second-look remain free of disease. In a multivariate analysis, residual tumor > 2 cm and stage IV disease were the most significant prognostic factors. The same analysis indicates that response to chemotherapy at second laparotomy is not an independent prognostic factor. In conclusion, our study indicates that the two most important prognostic factors in advanced ovarian carcinoma are the extent of the initial surgery and stage. (C) 1994 Academic Press, Inc.