复发性卵巢上皮性癌再次应用铂类药物的近期疗效及其相关因素分析

目的　探讨复发性卵巢上皮性癌 (卵巢癌 )再次应用铂类药物进行化学药物治疗 (化疗 )的近期疗效及其相关因素。方法　 1998年 1月～ 2 0 0 2年 10月收治对铂类药物敏感的卵巢癌患者 4 1例 ,回顾性分析 4 1例复发后再次应用铂类药物化疗的近期疗效 ,并选择年龄、初次手术结果、化疗疗程数、化疗是否规范、血清CA12 5水平、是否随访、复发间隔时间、复发部位及复发病灶数等 37个因素进行疗效分析。结果　再次应用铂类药物的近期有效率为 5 6 % ,无严重毒副反应 ;疗效与复发后化疗是否规范有显著相关性 (r=0 92 ,P <0 0 5 ) ,其中规范化疗的近期有效率为 76 % (19/ 2 5 ) ,不规范化疗为 2 5 % (4/ 16 )。近期有效率与其他因素无显著相关性 (P >0 0 5 )。结论　对铂类药物敏感的复发性卵巢癌患者可再次应用铂类药物化疗 ,其近期疗效与复发后是否规范化疗有关。     

以卡铂加紫杉醇作为一线化疗后仍有小残留灶的卵巢癌对拓普特肯的疗效

晚期卵巢癌行彻底减瘤术后通常选用卡铂/顺铂加紫杉醇方案化疗。经此一线方案化疗后仍有20％～30％病例有小的残留灶需要进一步处理。Ⅱ和Ⅲ期临床研究显示:拓普特肯(topotecan)对包括使用铂类治疗失败的卵巢癌病例有效。将其用于经卡铂加紫杉醇治疗后仍有残留灶的晚期卵巢癌患者。 为探讨拓普特肯疗效及毒性。将其选择使用一线化疗药物(标准的卡铂加紫杉醇方案)治疗后经剖腹术或腹腔镜证实有小的残留灶(直经<2cm),组织学证实为上皮性卵巢癌     

复发性卵巢上皮癌的处理

目的　探讨复发性卵巢癌复发的相关因素和二次肿瘤细胞减灭术的作用。方法　采用回顾性分析方法对我院 1 990年 1月～ 2 0 0 0年 1 2月收治的 2 1例复发性卵巢癌患者的治疗、复发、生存情况进行总结。结果　初次手术后残留癌灶直径≤ 2cm组与残留癌灶直径 >2cm组的平均复发时间分别为 2 8 9个月和 1 4 8个月 ,差异有显著性 (P <0 0 5 )。初次手术后进行C (A)P方案化疗与TP方案化疗的复发比例分别为 1 4 6 9(2 0 2 9% )和 7 1 8(38 89% ) ;初次手术 1年内化疗≥ 6疗程者与 <6疗程者的平均复发时间分别为 2 3 1个月和1 5个月 ,差异均无显著性 (P >0 0 5 )。二次肿瘤细胞减灭术及仅接受化疗的复发癌患者的平均生存时间分别为4 3个月和 1 9个月 ;2年生存率分别为 71 4 %和 2 8 6 % ,差异有显著性 (P <0 0 5 )。结论　初次手术后残留癌灶的大小、初次手术 1年内化疗疗程是复发的相关因素。复发癌二次肿瘤细胞减灭术与单纯化疗相比 ,可延长患者的生存时间。     

白蛋白结合型紫杉醇联合铂类或异环磷酰胺治疗复发性卵巢癌的疗效及安全性分析

目的:观察白蛋白结合型紫杉醇联合铂类或异环磷酰胺治疗复发性卵巢癌的临床疗效及毒副反应。方法:回顾分析我院46例复发性卵巢癌患者接受含不同制剂紫杉醇的联合化疗的疗效及安全性。26例铂敏感复发患者分别采用白蛋白结合型紫杉醇或溶剂型紫杉醇联合铂类化疗,20例铂耐药复发患者采用白蛋白结合型紫杉醇或溶剂型紫杉醇联合异环磷酰胺方案,每21天为1疗程,直至完全缓解后再巩固2个疗程或疾病进展或出现不可耐受的不良反应。比较患者间临床效果、毒副作用及预后差异。结果:铂敏感复发患者中,白蛋白结合型紫杉醇组的完全缓解率显著高于溶剂型紫杉醇组(60%vs 18.8%,P0.05);两组的客观缓解率分别为90%、75%。铂耐药复发患者中,白蛋白结合型紫杉醇组的完全缓解率显著高于溶剂型紫杉醇组(16.7%vs 0%,P0.05);两组的客观缓解率分别为66.7%、57.1%。铂敏感复发患者中,白蛋白结合型紫杉醇组及溶剂型紫杉醇组的中位无进展生存时间(PFS)分别为10.25、7.5个月(P0.05);铂耐药复发患者中白蛋白结合型紫杉醇组及溶剂型紫杉醇组的中位PFS分别为7.8、5.6个月(P0.05)。4组患者的不良反应主要表现为骨髓抑制和胃肠道反应,铂敏感、铂耐药患者中白蛋白结合型紫杉醇组及溶剂型紫杉醇组各种严重不良反应的发生率均无显著差异。结论:与溶剂型紫杉醇比较,含有白蛋白结合型紫杉醇的联合化疗方案治疗铂敏感或铂耐药复发性卵巢癌均有更高的完全缓解率,可有效延长PFS,且不额外增加严重毒副反应的发生率。     

紫杉醇在上皮性卵巢癌化疗中的双刃剑效应与对策思考

<正>1紫杉醇对卵巢癌的双刃剑效应及问题提出的缘由在上皮性卵巢癌(epithelial ovarian cancer,简称卵巢癌)的综合治疗中,化疗占有重要地位,是延缓卵巢癌患者复发与赖以长期生存的主要措施。晚期患者的手术很难达到无肉眼残留病变的程度,对于残留的癌灶,有赖于术后化疗来杀灭。     

卵巢癌细胞系CAOV3体外化疗后survivin mRNA表达的变化

目的　探讨卵巢癌细胞系CAOV3体外化疗后survivinmRNA表达的变化。方法　采用四甲基偶氮唑蓝 (MTT)比色法检测不同浓度 (分别为 2 0 0 0、2 0 0、2 0、2、0 2mg/L)紫杉醇或卡铂对CAOV3细胞体外生长的抑制作用。应用RT PCR技术检测高浓度紫杉醇或卡铂 (分别为 2 0 0、5 0 0mg/L)处理 1d ,低浓度紫杉醇或卡铂 (分别为 2 0、5 0mg/L)处理 1、3、5d后存活的卵巢癌细胞中survivinmRNA的表达水平 ,同时利用流式细胞仪检测细胞凋亡情况。结果　不同浓度 (分别为 2 0 0 0、2 0 0、2 0、2、0 2mg/L)紫杉醇或卡铂作用后CAOV3细胞的抑制率分别为 94 %、88%、34%、2 2 %、13%或 97%、4 6 %、14 %、9%、7% ,随着药物浓度的下降 ,细胞受抑制程度明显减弱 (P <0 0 5 )。低浓度紫杉醇处理1、3、5d后CAOV3细胞的凋亡率分别为 15 %、2 3%和 2 9% ;高浓度紫杉醇处理 1d后CAOV3细胞的凋亡率为 4 3%。低浓度卡铂处理 1、3、5d后CAOV3细胞的凋亡率分别为 14 %、2 2 %和 2 6 % ;高浓度卡铂处理 1d后CAOV3细胞的凋亡率为 19%。紫杉醇或卡铂低浓度处理 3d及高浓度处理 1d后存活的卵巢癌细胞中survivinmRNA的表达量均明显高于未加药的对照 (P <0 0 1) ,尤其是紫杉醇处理后存活的卵巢癌细胞中survivinmRNA的表达量增加更为明显     

卵巢癌化疗诱导周围神经病变的作用机制与临床研究进展

紫杉醇联合铂类化疗是晚期卵巢癌的一线标准化疗方案。化疗对提高临床有效率,延长患者无进展生存期及总体生存率有积极的意义,但可诱导周围神经病变(PN)发生,导致化疗延迟或停止,从而影响化疗药物的疗效。化疗诱导的周围神经病变(CIPN)症状持续存在影响卵巢癌患者的生存质量,因此了解化疗诱导CIPN的作用机制及危险因素尤为重要。本文就紫杉醇及铂类药物导致CIPN的发病机制及卵巢癌CIPN的发病率、危险因素、不良影响及防治研究进展进行综述。     

复发性上皮性卵巢癌的治疗

对复发性上皮性卵巢癌的处理一直是二分棘手和被关注的课题。手术加化疗仍是复发性卵巢癌的主要治疗方法，包括二次肿瘤减灭和二线化疗。复化性癌分为铂敏感和铂耐药肿瘤二大类。对铂敏感肿瘤再次采用铂为基础化疗仍可产生高的疗效；对铂耐药肿瘤可选用目前较有效的紫杉醇、异环磷酰胺和六甲密胺。     

卵巢透明细胞癌研究进展

卵巢透明细胞癌是特殊类型的上皮性卵巢癌,起源于苗勒氏管,与子宫内膜异位症关系密切.Ⅰ期病例相对较多,对传统的以铂类为主的化疗敏感性较差,预后不良.治疗上主张Ⅰ期病例同样需要行辅助化疗,晚期病例在最大限度肿瘤细胞减灭术的基础上,辅以化疗为主的综合治疗,紫杉醇、依立替康(irinotecan,CPT-11)、丝裂霉素等的有效率较高.     

穿刺活检与腹水细胞学检查用于晚期卵巢癌新辅助化疗前诊断的中国专家共识(2022年版)北大核心CSCD

约75%的卵巢上皮性癌(卵巢癌)患者在就诊时已是临床晚期[国际妇产科联盟(International Federation of Gyne⁃cology and Obstetrics,FIGO)Ⅲ~Ⅳ期]。目前,晚期卵巢癌[包括输卵管癌和原发性腹膜癌(以下简称为卵巢癌)]的初始治疗方式有两种[1-4]:(1)首选初次肿瘤细胞减灭术(primary debulking surgery,PDS)。(2)当评估PDS不能达到满意肿瘤减灭水平和(或)患者有围术期高风险因素时,新辅助化疗(neoadjuvant chemotherapy,NACT)+间歇性肿瘤细胞减灭术(interval debulking surgery,IDS)是替代选择。术后均须辅以铂类药物为基础的联合化疗以及适当方案的维持治疗,如聚腺苷二磷酸核糖聚合酶(PARP)抑制剂等[5-6],并强调卵巢癌全程管理模式的重要性。NACT+IDS虽是PDS的替代选择,但多个临床研究结果表明,NACT+IDS在无进展生存期(progression free survival,PFS)或总生存期(overall survival,OS)方面不逊于PDS,且围术期的并发症发生率和病死率均更低。     

卵巢上皮性癌的预后影响因素分析

目的 探讨卵巢上皮性癌(卵巢癌)的预后影响因素.方法 回顾性分析2002年1月至2005年12月在山西省肿瘤医院初诊的卵巢癌患者的临床病理资料.结果年龄、分期、病理类型、病理分化程度、术后残余瘤的大小以及术后化疗疗程数是卵巢癌的预后因素(P<0.01).以Ⅳ期患者的死亡风险为1,则Ⅰ期、Ⅱ期、Ⅲ期患者的死亡风险分别为0.005、0.106、0.361,95% CI分别为0.001～0.024、0.038～0.297、0.181～0.718(P<0.01);以术后残余瘤直径>2 cm患者的死亡风险为1,则残余瘤直径≤2 cm患者的死亡风险仅为0.307,95% CI为0.176～0.536(P<0.01);术后化疗疗程数<6个疗程患者的死亡风险为≥6个疗程者的8.191倍,95% CI为4.666～14.379(P<0.01).是否有恶性肿瘤家族史对卵巢癌预后无影响(P>0.05).结论 分期、术后残余瘤的大小、术后化疗的疗程数是卵巢痛的独立预后影响因素.尽力做到早诊断、早治疗,术后辅以正规、足疗程的化疗是提高卵巢癌生存率的关键.     

卵巢上皮性癌血清肿瘤标志物谱变化的临床意义

目的 探讨卵巢上皮性癌(卵巢癌)患者化疗后肿瘤标志物谱的变化及其潜在的临床意义.方法 选择1999年1月至2007年7月期间经肿瘤细胞减灭术及规范化疗的卵巢癌患者102例,对其术前、术后、每次化疗前、随访期间和复发前后的血清肿瘤标志物CA125、CA19-9和CP2的水平进行检测、分析,其中48例患者的肿瘤标志物记录完整而纳入分析,复发患者为28例,初治化疗患者20例(均为耐药病例).根据肿瘤标志物谱变化与否,分别将复发和初治化疗患者分为肿瘤标志物谱变化组与未变化组.平均随访时间为25个月.结果 (1)肿瘤标志物谱的主要变化表现为标志物的数最变化和(或)标志物的种类改变.28例复发患者中肿瘤标志物谱发生变化者占46%(13/28),20例初治化疗患者中标志物谱发生变化者占45%(9/20).(2)肿瘤标志物谱变化的复发患者中,病理类型以浆液性癌所占比例最高,为77%(10/13),而初治化疗患者中,以黏液性癌所占比例最高,为4/9.(3)复发患者肿瘤标志物谱变化组的无疾病进展期和中位总生存时间分别为22.2、60.0个月,较未变化组(分别为17.4、46.0个月)明显延长(P均<0.05);初治化疗患者肿瘤标志物谱变化组的中位总生存时间较未变化组(分别为15.9、25.0个月)明显缩短(P<0.05).结论 卵巢癌化疗期间和复发后肿瘤标志物谱可发生变化,化疗及随访期间应对肿瘤标志物进行联合检测.     

Primary chemotherapy and adjuvant tumor debulking in the management of advanced-stage epithelial ovarian cancer

The aim of this article was to review the experience with neoadjuvant chemotherapy and interval surgical debulking in patients with metastatic epithelial ovarian cancer. A retrospective chart review was carried out to identify patients treated with neoadjuvant platinum/Taxol chemotherapy and interval debulking. Cox regression modeling was used to identify significant predictors of progression-free interval. The Kaplan-Meier method was used to estimate the survival statistic for the study group. Sixty-one patients were identified after being treated with neoadjuvant chemotherapy and interval debulking surgeries. All surgeries were performed after three cycles of platinum/Taxol combination chemotherapy. Eighty percent of patients had a residual disease status of 2 cm or less after surgery. Suboptimal debulking was statistically associated with tumor involvement of the upper abdominal organs (P < 0.001) and non-normalization of CA125 before surgery (P= 0.03). The perioperative complication rate was 7%. At a mean follow-up time of 19 months, 77% of patients were still alive. Cox regression modeling identified the microscopic tumor residual status as the only significant predictor of progression-free interval. The estimated median survival for the group was 41.70 months (95% confidence interval = 13.84-69.56 months). Neoadjuvant chemotherapy with interval debulking surgery appeared to be safe and feasible in patients with metastatic epithelial ovarian carcinoma.     

The role of topotecan as second-line therapy in patients with recurrent ovarian cancer

INTRODUCTION: Up to 80% of patients with advanced ovarian cancer will recur following first-line platinum containing chemotherapy. Topotecan has recently been used as a second-line agent in treatment of advanced ovarian disease. The aim of the study was to evaluate the effect of topotecan on response rate and progression-free interval on patients with recurrent ovarian cancer who had been treated with platinum-containing first-line chemotherapy. METHODS: A retrospective review of all cases of recurrent ovarian cancer treated with topotecan was done. Response was determined using radiologic reports (CT scans, ultrasound scans), CA-125 level and the clinical evaluation. Response type was determined using World Health Organization (WHO) criteria. RESULTS: Between 1998-2000, a total of 43 patients were treated with topotecan. Median age was 57 (range 41-80), 40/43 patients had stage III and IV, 37/43 patients had Grade 3 tumors. Seventeen of 43 patients (39.5%) demonstrated stable disease and 9/43 (21%) patients demonstrated partial response. Median time to response was eight weeks, median progression-free interval was 31 weeks and median time of follow-up and survival was 48 weeks. CONCLUSION: Topotecan is considered a reasonable option for treatment of patients with recurrent ovarian cancer that have failed previous treatment with platinum-containing chemotherapy.     

Is stabilization of disease a useful indicator for survival in second-line treatment of ovarian carcinoma pre-treated with Paclitaxel-Platinum?

OBJECTIVE: Recurrent ovarian carcinoma is considered an incurable disease and second-line chemotherapy is administered for extension of survival and palliation. The impact of continued antineoplastic treatment in patients with stable disease without a demonstrable response is uncertain. The aim of this analysis was to assess the value of a stabilization of the tumor size in second-line chemotherapy as an indicator of survival. METHODS: Retrospective, single-institution study of 487 consecutive patients with primary epithelial ovarian carcinoma. Inclusion criteria: (1) FIGO stage IC-IV epithelial ovarian carcinoma; (2) first-line chemotherapy with Paclitaxel and a Platinum-compound; (3) refractory, persistent, or recurrent disease diagnosed by imaging methods; and (4) intravenous second-line chemotherapy with single Topotecan or Paclitaxel-Carboplatin. Univariate and multivariate analyses of survival with the World Health Organization (WHO) tumor response parameter included as a time-dependent variable were performed. RESULTS: The response rates were (N = 100): complete response (CR) 27%, partial response (PR) 14%, stable disease (SD) 41% and progressive disease (PD) 18%. In a multivariate Cox regression analysis of survival, SD was found to be an independent prognostic factor for survival and the death hazard ratio was 0.37 (SD versus PD; 95% CI: 0.16-0.86; P = 0.02). There was no statistically significant difference in survival between patients with PR and SD (P = 0.09). CONCLUSION: In second-line chemotherapy of ovarian cancer, patients demonstrating SD have a survival benefit compared to patients with PD measured by the WHO tumor response criteria.     

Secondary cytoreductive surgery for recurrent epithelial ovarian cancer

Thirty patients with recurrent epithelial ovarian carcinoma who underwent secondary tumor-reductive surgery at M. D. Anderson Cancer Center were studied retrospectively. All had been initially treated by primary reductive surgery and postoperative chemotherapy and had a period of clinical remission of at least 6 months thereafter. Ninety percent of patients had grade 2 or 3 tumors. In 17 (57%), residual tumor volume was reduced to less than 2 cm. There were no postoperative deaths, but 40% of patients suffered postoperative morbidity, mostly prolonged ileus. Median survival after second surgery was 16.3-18 months for patients with residual tumor volume less than 2 cm and 13.3 months for those with residual volume greater than 2 cm (nonsignificant). When the second surgery followed the first by less than 18 months, survival was a median of 13.5 months after the second operation as compared with 19 months when the interval was 18 months or longer (nonsignificant). Twenty-two patients received postsurgical chemotherapy; only 11% of those who were evaluable responded. Although secondary tumor-reductive surgery for recurrent ovarian cancer is technically feasible, in the absence of an efficacious second-line medical therapy, its value is limited.     

Cisplatin as second-line therapy in ovarian carcinoma treated initially with single-agent paclitaxel: a Gynecologic Oncology Group study

OBJECTIVES: The platinum compounds are the most active agents in the treatment of ovarian carcinoma. Phase II trials demonstrated the activity of paclitaxel in patients with disease clinically resistant to platinum-based front-line therapy, and phase III studies confirmed that a combination of paclitaxel plus a platinum was superior to cyclophosphamide plus a platinum. This study evaluated the activity of platinum in patients with bulky advanced disease treated with single-agent paclitaxel as front-line therapy on a Gynecologic Oncology Group protocol. Those patients who had persistent (stable) or progressive disease while receiving paclitaxel, or a recurrence of disease within 6 months of completing six cycles of paclitaxel therapy, received single-agent cisplatin. METHODS: Thirty-nine eligible patients with ovarian carcinoma persistent, progressive, or recurrent after initial treatment with paclitaxel 200 mg/m(2) over 24 h every 3 weeks received cisplatin 100 mg/m(2) every 3 weeks until disease progression or unacceptable toxicity. RESULTS: Among 37 patients evaluable for response, 8 complete (22%) and 13 partial (35%) responses resulted. Twelve (32%) patients exhibited stable disease, while 4 (11%) had increasing disease. Median progression-free survival was 11.0 months. Median survival was 15.0 months. All but two patients were clinically resistant to paclitaxel (progression during or within 6 months after completion of paclitaxel). Grade 2 or worse adverse effects among 39 patients evaluable for toxicity included neutropenia (23), thrombocytopenia (3), anemia (10), nausea and vomiting (23), azotemia (7), neurotoxicity (9), fever (2), and tinnitus (1). CONCLUSION: These data provide evidence that cisplatin is active as second-line therapy in patients clinically resistant to paclitaxel. The overall response rate is high (57%) with excellent progression-free and overall survival in the second-line setting.     

Five-Year Survival after Second-Line Cisplatin-Based Intraperitoneal Chemotherapy for Advanced Ovarian Cancer

Background.To evaluate the 5-year survival rates of second-line intraperitoneal chemotherapy in advanced-staged ovarian cancer.Materials and Methods.Between August 1985 and September 1991, 63 patients with advanced epithelial ovarian cancer received intraperitoneal cisplatin and cytarabine chemotherapy as second-line treatment.Results.The median survival from the time of initiation of intraperitoneal chemotherapy (IPC) was 29.1 months. A significant advantage in 5-year survival (40%) and 5-year progression-free survival (37%) was observed among 21 patients who demonstrated a response to first-line and second-line treatment compared to those who demonstrated a response to first-line treatment only (6 and 0%, respectively) (P< 0.0001). No patient (n= 13) who failed to respond to either first-line or second-line treatment survived for 5 years. Among 42 patients with ≤5 mm residual disease at the time of initiation of IPC, 5-year survival was 36% and 5-year progression-free survival was 31%, while no patient (n= 21) with residual disease measuring >5 mm at the initiation of IPC survived 5 years (P< 0.0001).Conclusion.Given the limitation that this is not a randomized trial, the data appear to indicate that salvage platinum-based intraperitoneal chemotherapy results in significant 5-year survival and progression-free survival in selected patients who initiated therapy with small (≤5 mm) tumor burden. These survival rates as second-line therapy approach those achieved by first-line platinum-based intravenous chemotherapy in patients with advanced-stage ovarian cancer with similar small residual disease at the initiation of therapy.     

晚期卵巢上皮性癌患者初次治疗过程中血清CA125水平变化与其预后的关系

目的 探讨晚期(Ⅲ～Ⅳ期)卵巢上皮性癌(卵巢癌)患者初次治疗过程中血清CA125水平变化与其预后的关系.方法 选择1998年1月-2003年12月间中山大学肿瘤防治中心妇瘤科收治的142例晚期卵巢癌患者,回顾性分析其初次治疗过程中血清CA125水平的变化,采用Kaplan-Meier法计算其累积生存率,并采用Cox风险比例回归模型分析血清CA125水平的变化对患者预后的影响.结果 根据患者治疗前血清CA125水平不同分为≤500、>500～1500和>1500 kU/L,其3年累积生存率(分别为64%、71%及64%)比较,差异无统计学意义(P>0.05).术后接受3个疗程化疗后,血清CA125水平降至正常(0～35 kU/L)的77例患者的3年及5年累积生存率分别为84%及56%,明显高于血清CA125水平仍为异常的48例患者(分别为42%、15%,P<0.01).多因素分析表明,残留灶直径(P<0.01)及3个疗程化疗后血清CA125水平(P<0.01)是影响晚期卵巢癌患者预后的独立的因素.进一步分层分析表明,接受了满意的肿瘤细胞减灭术(残留灶直径≤1 cm)的患者中,3个疗程化疗后血清CA125水平降至正常者的3年及5年累积生存率分别为88%、64%,明显高于化疗后血清CA125笛水平仍为异常者(分别为52%、18%,P<0.01);同样,接受了不满意的肿瘤细胞减灭术(残留灶直径>1 cm)的患者中,3个疗程化疗后血清CA125水平降至正常者的3年和5年累积生存率分别为74%、32%,明显高于化疗后血清CA125水平仍为异常者的33%、13%(P<0.01).结论 3个疗程化疗后血清CA125水平正常与否可预测晚期卵巢癌患者的预后,且无论初次手术是否为满意的肿瘤细胞减灭术,3个疗程化疗后血清CA125水平降至正常者较未降至正常者预后好.     

原发性卵巢黏液性癌的临床特征分析

目的:探讨原发性卵巢黏液性癌的临床特点,寻求恰当的治疗策略。方法:回顾分析24例卵巢黏液性癌和108例非黏液性癌患者的年龄、手术病理分期、残留病灶、化疗反应率,比较生存情况,分析影响预后的因素。结果:黏液性癌患者FIGO分期早(P=0.001)、肿瘤分级低(P=0.000)。两组患者的年龄没有差异,Ⅲ～Ⅳ期患者的手术满意率无差异(P=0.453)。黏液性癌组与非黏液性癌组初治时对紫杉醇+卡铂的化疗反应率无差异(63.2%vs 85.2%,P=0.212),黏液性癌组的耐药病例似乎与肿瘤分期、手术满意度无关,而且复发后耐药率明显升高至60%。黏液性癌组和非黏液性癌组患者的总体中位无进展生存期(PFS)(22个月vs 17个月,P=0.393)和中位总生存期(OS)(22个月vs 37.5个月,P=0.670)无差异。Ⅰ～Ⅱ期黏液性癌与非黏液性癌两组患者中位PFS(37.5个月vs 44个月,P=0.304)和OS(49个月vs 45个月,P=0.621)亦无差异。满意肿瘤细胞减灭术后的Ⅲ～Ⅳ期患者,黏液性癌组中位PFS比非黏液性癌组短(12个月vs27个月,P=0.003),中位OS也缩短(18个月vs 45个月,P=0.044);不满意肿瘤细胞减灭术后的Ⅲ～Ⅳ期患者两组中位PFS(7.5个月vs 16个月,P=0.533)和中位OS(18个月vs 33个月,P=0.192)无统计学差异。Cox多因素回归分析结果提示,影响患者无进展生存期的因素包括肿瘤病理类型、FIGO分期和手术满意度;而影响总生存期的因素只有手术满意度。结论:卵巢黏液性癌是上皮癌的一个独立类型,晚期黏液性癌患者比非黏液性癌预后差,化疗耐药可能是预后差的原因,需要筛选有效的化疗方案。