Cytoreductive surgery for recurrent ovarian cancer
Cytoreductive surgery for recurrent ovarian cancer
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DOI：
10.1097/gco.0b013e3280115f40
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发表时间：
2007-02-01
影响因子：
2.1
通讯作者：
Covens, Allan
中科院分区：
文献类型：
--
作者：
Hauspy, Jan;Covens, Allan
回顾的目的在过去的三十年里，临床医生管理卵巢癌所面临的问题已经从治疗治愈和随后的姑息治疗发展到延长大多数患者的生存期。本文的目的是审查的数据，基本原理，和周围的复发性卵巢癌细胞减灭术及其潜在作用的问题，在这个新的范式transition.Recent findingsAbundant回顾性系列报告延长生存与二次细胞减灭术复发性卵巢癌。然而，选择偏倚、发表偏倚和后续治疗是影响生存率的混杂因素。由于卵巢癌的管理最近已经发展到一种“慢性疾病”的治疗，手术（在主要治疗中有明确的作用）应被考虑。由于缺乏良好的数据，临床医生在如何最好地管理患者方面没有明确的方向。具有良好特征的患者，如无病间期长、体能状态良好、单个或少数小的腹腔内复发，可能受益于二次减瘤术。需要进行前瞻性随机研究。
Purpose of reviewThe issue facing clinicians managing ovarian cancer has evolved over the past three decades from treatment for cure and subsequently palliation to prolongation of survival for most patients. The purpose of this paper is to review the data, rationale, and issues surrounding cytoreductive surgery in recurrent ovarian cancer and its potential role in this new paradigm shift.Recent findingsAbundant retrospective series report prolongation of survival with secondary cytoreductive surgery in recurrent ovarian cancer. Selection bias, publication bias, and subsequent therapies, however are confouding factors for survival. As management of ovarian cancer has recently evolved to a treatment of a 'chronic disease', surgery (which has a definite role in primary therapy) should be considered.SummaryNo prospective randomized studies have been performed to date, and therefore adoption of this method of management has been limited. The absence of good data leaves clinicians without clear direction on how to best manage patients. Patients with favorable characteristics such as a long disease free interval, good performance status, a single or few small intra-abdominal recurrences may benefit from secondary cytoreduction. A prospective randomized study is needed.