Clinical Management of Ovarian Small-Cell Carcinoma of the Hypercalcemic Type A Proposal for Conservative Surgery in an Advanced Stage of Disease
Clinical Management of Ovarian Small-Cell Carcinoma of the Hypercalcemic Type A Proposal for Conservative Surgery in an Advanced Stage of Disease
复制标题
DOI：
10.1111/igc.0b013e3181a1a116
复制
发表时间：
2009-04-01
影响因子：
4.8
通讯作者：
van der Burg, Maria E. L.
中科院分区：
文献类型：
--
作者：
Dykgraaf, Ramon H. M.;de Jong, Diederick;van der Burg, Maria E. L.
高钙型卵巢小细胞癌是一种罕见的高度恶性肿瘤。在三分之二的患者中，肿瘤与无症状的副肿瘤性高钙血症有关。可能妨碍诊断;这种肿瘤必须与其他具有类似特征的肿瘤相区别。2这种肿瘤主要发生在年轻女性，仅是致命的。1年生存率仅为50%，5年总生存率约为10%。认为以根治性手术、化疗和放疗相结合为特征的经验性治疗在生存方面产生最有利的结果。然而，尽管采取了这种积极的方法，结果仍然非常差。或者，这些低生存率可能证明不那么积极的生育保留方法是合理的，而不会影响结果。这种方法是说明了一个病例报告，涉及卵巢小细胞癌的高钙型，FIGO阶段IIIC的患者。采用保留生育力的方法，包括保守手术，然后诱导化疗，间隔减瘤手术和局部放疗。在60个月的随访中，没有证据表明疾病和正常的月经周期恢复。除了本病例报告，组织病理学特征，不同的治疗方式，和结果的高钙型卵巢小细胞癌进行审查。这份报告表明，保留生育率的方法可能与普遍采用的积极方法一样可行。
Ovarian small-cell carcinoma of the hypercalcemic type is a rare and highly malignant tumor. In two thirds of the patients, the tumor is associated with asymptomatic paraneoplastic hypercalcemia. The diagnosis may be impeded; the tumor must be distinguished from other tumors with similar features.This tumor occurs predominantly in young women and is merely lethal. The 1-year survival is solely 50%, with an overall 5-year survival rate of approximately 10%. It is believed that the empirical treatment characterized by combination of radical surgery, chemotherapy, and radiotherapy results in the most favorable outcome in terms of survival. However, the outcome remains extremely poor despite this aggressive approach.Alternatively, these poor survival rates may justify a less aggressive fertility sparing approach without compromising the outcome. Such an approach is illustrated by a case report involving a patient with ovarian small-cell carcinoma of the hypercalcemic type, FIGO stage IIIC. A fertility-sparing approach was used, consisting of conservative surgery followed by induction chemotherapy, interval debulking surgery, and local radiotherapy. During follow-up of 60 months, there was no evidence of disease and the normal menstrual cycle resumed.In addition to this case report, histopathological features, different therapeutic modalities, and outcome of ovarian small-cell carcinoma of the hypercalcemic type is reviewed. This report suggests that a fertility-sparing approach may be just as feasible as the generally applied aggressive approach.