复发性卵巢恶性肿瘤再次手术的意义

目的探讨复发性卵巢恶性肿瘤再次手术的指征和临床意义。方法回顾性分析复发性卵巢恶性肿瘤28例共39次再次手术的临床资料。根据病理类型分为上皮性卵巢癌组和其他类型组,上皮性卵巢癌组又根据复发时间分为>6个月组、≤6个月组和肿瘤进展组。依据复发灶的数目分为单病灶组和多病灶组两组。观察比较每组再手术的满意减灭术例数,手术并发症例数及术后生存时间。结果上皮性卵巢癌组中单病灶组获得满意减灭术67.8%,多病灶组为45.4%,上皮性卵巢癌生存时间中位数11个月,其中>6个月组,≤6个月组和进展组生存时间分别为14.5个月,10个月和6个月,而其他类型组2年存活率82%(7/8),5年存活率50%(4/8)。手术并发症以多病灶组为高。结论单病灶复发,停止化疗>6个月复发者再次手术可以获得较满意疗效;非上皮癌则不受此限制。

Recytoreductive surgery for recurrent malignant ovarian neoplasm

Objective To evaluate the role of recytoreductive surgery in recurrent malignant ovarian neoplasm.Methods 39 Operatins were performedin 28 cases who had recurrent malignant ovarian neoplasm.They were divided into two groups firstly according to the pathological type.group A,epithelial ovary carcinoma.group B,Non-epithelial ovary carcinoma.Then they were divided into 3 groups according to the sensitivity to chemotherapy.Group Ⅰ:diseases relapsed more than 6 months after chemotherapy;Group Ⅱ:relapsed less than 6 months;Group Ⅲ:relapsed during chemotherapy.According to the recurrent lesion divide into two groups (single lesion and disseminated lesions).We reviewed the cases with regard to its macroscopic residual disease,complications of operation and postoperation survival time.Results Recytoreductive surgery for patients with recurrent tumor were optimal in 67.8% isolated lesion and 45.4%disseminated lesions.The mean survive time of epithelial ovarian cancer was 11 months.Group Ⅰ,group Ⅱ and group Ⅲ were respectively 14.5 months,10 months and 6 months,and non-epithelial ovary neoplasm 2 year survival rate 82%(7/8),5-year survival rate 50%(4/8).Disseminated lesions had more complications than single lesion.Conclusions Recytoreductive surgery should be consided in patients with isolated recurrent ovarian cancer and patient with recurrence more than 6 months after chemotherapy.Non-epithelial neoplasm is not affected by above conditions.