Can advanced-stage ovarian cancer be cured?
Can advanced-stage ovarian cancer be cured?
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DOI：
10.1038/nrclinonc.2015.224
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发表时间：
2016-04-01
影响因子：
78.8
通讯作者：
Narod, Steven
中科院分区：
文献类型：
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作者：
Narod, Steven
大约20%的晚期卵巢癌患者在治疗后存活超过12年，并得到有效治愈。卵巢癌的初步治疗包括手术和化疗，目的是根除尽可能多的癌细胞。事实上，治疗的三个阶段如下：尽可能多地切除癌症的手术，最好是没有明显残留疾病的状态；化疗，以根除手术后仍然存在的任何微小疾病；以及二线或维持治疗，用于延缓肿瘤复发患者的疾病进展。如果在初步治疗完成后没有癌细胞残留，那么治愈是有希望的。相比之下，如果在最初的治疗后存在残留的癌细胞，那么疾病很可能复发。因此，治愈的可能性取决于手术和化疗的结合，有效地消除了所有的癌细胞。在这篇展望文章中，我提出了通过最大限度的去髓核手术和腹膜内化疗的组合，达到无癌状态的可能性最大化的情况。我讨论的证据表明，通过采取这种方法，可以治愈高达50%的晚期卵巢癌妇女。
Approximately 20% of women with advanced-stage ovarian cancer survive beyond 12 years after treatment and are effectively cured. Initial therapy for ovarian cancer comprises surgery and chemotherapy, and is given with the goal of eradicating as many cancer cells as possible. Indeed, the three phases of therapy are as follows: debulking surgery to remove as much of the cancer as possible, preferably to a state of no visible residual disease; chemotherapy to eradicate any microscopic disease that remains present after surgery; and second-line or maintenance therapy, which is given to delay disease progression among patients with tumour recurrence. If no cancer cells remain after initial therapy is completed, a cure is expected. By contrast, if residual cancer cells are present after initial treatment, then disease recurrence is likely. Thus, the probability of cure is contingent on the combination of surgery and chemotherapy effectively eliminating all cancer cells. In this Perspectives article, I present the case that the probability of achieving a cancer-free state is maximized through a combination of maximal debulking surgery and intraperitoneal chemotherapy. I discuss the evidence indicating that by taking this approach, cures could be achieved in up to 50% of women with advanced-stage ovarian cancer.