晚期卵巢上皮性癌新辅助化疗与耐药的研究进展

新辅助化疗(NACT)是治疗晚期卵巢上皮性癌的重要方式,能有效提高肿瘤细胞减灭术的满意率,但与初始肿瘤细胞减灭术比较,这一标准治疗方法未提高晚期卵巢上皮性癌患者的生存率,晚期卵巢上皮性癌患者5年生存率仅为30%～40%。已有大量研究表明NACT是诱导化疗耐药的重要因素,而化疗耐药则是导致晚期卵巢上皮性癌患者NACT后预后差的重要因素,因此晚期卵巢上皮性癌的初始治疗仍存在一定的争议性。NACT诱导化疗耐药的机制尚不清晰,现有研究主要在耐药基因及肿瘤干细胞等方面,因此进一步探索NACT与耐药的相关机制、逆转肿瘤细胞化疗耐药是提高晚期卵巢上皮性癌患者生存率亟待解决的问题。     

晚期卵巢上皮性癌初次手术影响因素及预后分析

目的:探讨行初次肿瘤细胞减灭术的晚期卵巢上皮性癌的预后以及影响手术结果的因素.方法:应用SPSS 11.5统计学软件对2003～21307年我院收治的行初次肿瘤细胞减灭术的晚期卵巢上皮性癌111例的临床情况进行统计分析.结果:晚期卵巢上皮性癌的3年生存率为37.8%,5年生存率为11.7%.单因素分析表明,分期晚、分化差、非浆液性病理类型、合并胸水、合并上腹部转移、术后化疗少于6疗程、术后出现并发症者预后差.多因素分析表明残余病灶、组织学分化以及并发症是影响预后的独立因素.合并上腹部转移、低分化、非浆液性易降低满意的肿瘤细胞减灭术的比例从而影响预后.结论:临床期别、组织学分化、病理类型、术后化疗疗程、术后并发症、是否合并上腹部转移及胸水是影响晚期卵巢上皮性癌预后的因素,其中残余病灶、组织学分化以及并发症是影响预后的独立因素.晚期卵巢上皮性癌较易发生上腹部转移,合并上腹部转移影响手术满意减灭率.应积极的行肿瘤细胞减灭术.术后辅以铂类为基础的6疗程化疗.     

透明细胞癌的手术治疗

透明细胞癌对化疗不敏感。如果术中有癌组织残留．预后极差。同期别的透明细胞癌较浆液性腺癌预后明显不良。所以，手术疗法对卵巢透明细胞癌尤为重要。通常．Ⅲ和Ⅳ期卵巢癌细胞减灭使残存肿瘤也cm。可改善预后：最近又有〈1cm可更大程度改善预后的报道。据研究,Ⅲ和Ⅳ期透明细胞癌残留1cm和超过1cm的肿瘤预后几乎相同。所以．透明细胞癌必须将肿瘤细胞清除至0．即要切除极少残留肿瘤的部位。     

晚期卵巢上皮性癌的综合治疗和预后分析

目的：对晚期卵巢上皮性癌的综合治疗进行研究,并对其预后因素加以分析,方法：选择复旦大学附属肿瘤医院1998年1月至2000年12月收治的晚期卵巢上皮性癌患者53例（研究组）,给予综合治疗即诱导缓解,巩固治疗和免疫支持治疗,另选择1986年1月至1997年、12月间收治的晚期卵巢上皮性癌患者318例（对照组）,给予肿瘤细胞减灭术及常规化学药物治疗（化疗）。结果：研究组的完全缓解率,部分缓解率分别为90．6％,5．7％,均明显高于对照组的70．1％,5．3％（P＜0．01）,研究组的1,2,3年生存率分别为97．7％,89．1％,83．6％,均明显高于对照组的71．8％,44．1％,29．8％（P＜0．01）,研究组的1,2,3年无癌生存率分别为92．6％,70％,75．0％,均明显高于对照组的60．3％,37．8％,28．6％（P＜0．01）,研究组1,2年的肿瘤复发率分别为7．5％,25．0％,均明显低于对照组的39．7％,62．2％（P＜0．01）,和预后有关的因素有年龄,首治医院,手术病理分期,腹水,病理分化程度,术前化疗,术后腹腔化疗和静脉化疗,和无癌生存相关的预后因素是首治医院,卵巢侵犯程度,残留癌直径大小和术后腹腔化疗,结论：通过诱导缓解,巩固治疗和免疫支持治疗可提高疗效,明显降低了晚期卵巢上皮性癌的1,2年复发率,提高了晚期上皮性癌的生存率。     

中间性肿瘤细胞减灭术在晚期卵巢上皮性癌中的治疗价值

卵巢上皮性癌发病隐蔽,恶性程度高,晚期患者预后差,传统的初次肿瘤细胞减灭术对于晚期患者常常难以达到理想肿瘤细胞减灭,而术前化疗的广泛应用使得中间性肿瘤细胞减灭术(ICS)受到越来越多的关注.因此就:ICS的概念、发展历程、手术切除率,生存结局、相关并发症以及对晚期卵巢上皮性癌的治疗价值进行综述.     

卵巢透明细胞癌70例临床分析

目的:探讨卵巢透明细胞癌的临床特点、预后及与子宫内膜异位症的关系.方法:对70例原发性卵巢透明细胞癌患者回顾性分析其治疗方法、对化疗的敏感性和生存率,以及合并子宫内膜异位症患者对化疗的敏感性和生存率.结果:根据FIGO分期,70例中工期44例,Ⅱ期13例、Ⅲ期13例.70例总的5年生存率为48.97%.患者全部进行手术,其中满意肿瘤细胞减灭术62例,占88.6%(62/70);不满意肿瘤细胞减灭术8例,占11.4%(8/70).两组5年生存率分别为61.52%和7.69%(P＜0.05).术后5例放弃化疗,65例于术后1～2周内进行了以PT、PAC等共3至8个疗程化疗.是否合并子宫内膜异位症对化疗的敏感性和生存率无统计学差异.结论:卵巢透明细胞癌临床特点不同于其他的卵巢上皮性恶性肿瘤,其临床分期早,化疗不敏感,易复发,预后差.伴有子宫内膜异位症与否与预后无相关性.     

高精度持续循环腹腔热灌注化疗联合静脉化疗治疗卵巢浆液性囊腺癌的临床研究

目的:探讨高精度持续循环腹腔热灌注化疗(CHPPC)联合静脉化疗(IC)对卵巢浆液性囊腺癌满意肿瘤细胞减灭术后患者的疗效及毒副作用。方法:将60例卵巢浆液性囊腺癌满意肿瘤细胞减灭术后患者随机分为实验组和对照组(每组30例),实验组给予CHPPC+IC,对照组给予IC。结果:实验组和对照组中血清CA125半衰期20天者分别占76.67%、43.33%,差异显著(P0.05)。按PECIST指南推荐的实体瘤评价标准,实验组和对照组的有效率分别为80.00%和53.33%,差异显著(P0.05)。实验组和对照组的胃肠道反应发生率分别为96.67%和80.00%,差异显著(P0.05),余不良反应均无显著差异。随访15个月,实验组和对照组的复发率分别为13.33%和36.67%,生存率分别为90.0%和70.0%,差异均有统计学意义(P0.05)。结论:CHPPC+IC治疗卵巢浆液性囊腺癌安全、可行、可耐受,能显著提高生存率、减少复发率。     

透明细胞癌的一、二线化疗方案[日]

欧美妇科肿瘤大规模临床试验中，把紫杉醇加卡铂（TJ）疗法作为治疗卵巢癌的一线化疗方案。但其中大半为浆液性腺癌和子宫内膜样癌．透明细胞癌为3．9％，黏液性腺癌占2．4％。所以TJ疗法仅可作为卵巢未分化腺癌、子宫内膜样腺癌、浆液性腺癌的一线化疗方案。而TJ疗法能否作为透明细胞的一线化疗方案呢？     

晚期卵巢上皮性癌化学药物治疗的意义及远期疗效的影响因素

目的：探讨晚期卵巢上皮性癌化学药物治疗（化疗）的意义及远期疗效的影响因素,方法：自1986年1月至1997年12月我院收治晚期卵巢上皮性癌患者348例,根据残留癌直径的大小分为切净组（残留癌直径≤1cm)和未切净组（残留癌直径＞1cm),Log-rank检验分析两组患者的生存率差异,Logistic回归模型分析影响远期分别为46个月和36个月,差异有显著性（χ^2=7.39,P=0.0065);未切净组患者术后静脉化疗＞6个疗程与≤6个疗程的中位生存期分别是22个月和11个月,差异有显著性（χ^2=4.31,P=0.0380）,多因素分析结果显示,切净组患者的预后与术后腹腔化疗有关;而未切净组患者的预后则与术后静脉化疗,术前化疗（P＜0．01）,和病理分级（P＜0．05）有关,晚期卵巢上皮性癌患者的远期疗效主要与残留癌直径（P＜0．01）,术后腹腔化疗（P＜0．05）,病理分级（P＜0．05）有关,结论：术后给予＞6个疗程的静脉化疗改善了晚期卵巢上皮性癌未切净组患者的近期疗效,但远期疗效无明显改善,腹腔化疗与晚期卵巢上皮性癌患者的远期疗效有关,邮切净组患者的生存期。     

腹膜浆液性乳头状腺癌的临床分析

目的探讨腹膜浆液性乳头状腺癌(腹膜浆乳癌)的临床特点及治疗。方法对1984年至2002年收治的14例腹膜浆乳癌和50例卵巢浆液性乳头状腺癌(卵巢浆乳癌)患者的临床表现、治疗效果及生存率进行回顾性对比分析。结果腹膜浆乳癌患者的平均年龄为62 7岁,卵巢浆乳癌患者的平均年龄为53 6岁,两者比较,差异有统计学意义(P<0 01)。腹膜浆乳癌患者有腹水12例(86%, 12 /14),有盆腹腔包块10例(71%, 10 /14);血清CA125平均水平为2289kU/L。卵巢浆乳癌患者有腹水40例(80%, 40 /50),有盆腹腔包块45例( 90%, 45 /50 );术前血清CA125平均水平为1741kU/L。两者分别比较,差异均无统计学意义(P>0 05 )。腹膜浆乳癌患者中12例行肿瘤细胞减灭术,术后均行化疗,对化疗耐药者10例(83%, 10 /12);另2例于手术前死亡。卵巢浆乳癌50例患者均行肿瘤细胞减灭术,术后均行化疗,对化疗耐药者19例(38%, 19 /50)。两者各项比较,差异均有统计学意义(P<0 05)。腹膜浆乳癌患者1、2、3年的生存率分别为72%、10%、0;卵巢浆乳癌患者分别为95%、79%、62%。两者分别比较,差异均有统计学意义(P<0 05)。结论腹膜浆乳癌患者较卵巢浆乳癌患者的发病年龄高,化疗效果及预后差。     

Low proliferation activity may be associated with chemoresistance in clear cell carcinoma of the ovary

OBJECTIVE: To estimate whether and how the biologic behavior of clear cell carcinoma contributes to the chemoresistance mechanism. METHODS: Forty-one patients with clear cell carcinoma and 90 patients with serous adenocarcinoma, who had measurable disease after initial surgery, were examined. All patients underwent cytoreductive surgery followed by platinum-based chemotherapy. P-glycoprotein, multidrug resistance-associated protein, and Ki-67 expression were determined by immunohistochemical staining. RESULTS: The 5-year survival rate for patients with clear cell carcinoma was significantly poorer, compared with serous adenocarcinoma (20.0% versus 31.9%). Response rate to chemotherapy was 14.6% for clear cell carcinoma and 72.2% for serous adenocarcinoma. The expression of P-glycoprotein and multidrug resistance-associated protein did not differ between responders and nonresponders in both tumor types. The Ki-67 labeling index (LI) in clear cell carcinoma was significantly lower than serous adenocarcinoma (18.4% versus 38.8%). The LI for responders was significantly higher than that for nonresponders in both tumor types. In clear cell carcinoma, the mean value of LI was 15.3% for nonresponders, but that for responders was 30.2%, which was similar to that for serous adenocarcinoma. When the cutoff value of LI was set at 18.4% (mean value), the 5-year survival rate for high LI (over 18.4%) patients was significantly greater than that for low LI patients (46.3% versus 9.2%). Multivariable analysis revealed that LI and residual tumor size were the independent prognostic factors. CONCLUSION: Lower proliferation of tumor may be a behavior of clear cell carcinoma of the ovary that contributes to its resistance to chemotherapy.     

Clear cell adenocarcinoma of the ovary: a clinical analysis and comparison with serous carcinoma

Forty-four patients with clear cell adenocarcinoma of the ovary diagnosed between 1944 and 1981 were compared with a matched cohort of 55 patients with the most common epithelial malignant lesion, serous adenocarcinoma, in terms of their presentation and clinical course. None were lost to follow-up. Median follow-up was 9 years. Fifty percent of clear cell patients presented in Stage I versus 31% of serous patients. Patients with clear cell carcinoma presented more often with pelvic masses (84% vs 65%) and had larger (diameter greater than 10 cm) primary tumors (73% vs 29%). Forty-nine percent of clear cell patients were nulligravid compared with 24% of serous patients and endometriosis was strikingly more common in clear cell patients (58% vs 12%). When compared stage for stage, clear cell tumors were uniformly associated with poorer 5-year survival rates with an overall rate of 34%. In patients with recurrent disease, lymph node involvement was much more common in patients with clear cell carcinoma (40% vs 7%). Parenchymal organ involvement was also more common in the clear cell group (40% vs 13%). Ovarian clear cell adenocarcinoma has distinctly different clinical behavior compared to serous carcinoma and should be regarded as an aggressive epithelial histologic type.     

Optimal surgical cytoreduction in patients with Stage III and Stage IV endometrial carcinoma: a study of morbidity and survival

OBJECTIVE: To evaluate the survival impact of residual disease at the time of primary surgery for patients with Stage III and IV endometrial carcinoma; to assess morbidity associated with surgical cytoreduction. METHOD: All patients with endometrial carcinoma who underwent primary surgical therapy at the University of Miami between January 1, 1990 and June 1, 2002 were identified. Patients meeting FIGO criteria for Stage III or IV disease were selected. Papillary serous and clear cell histology was excluded. RESULTS: Eighty-five patients were identified: 66 Stage III and 19 Stage IV. Only Stage IIIC and Stage IV were included in survival analysis: 72% (33 Stage IIIC, 9 Stage IV) had optimal cytoreduction and 28% (6 Stage IIIC, 10 Stage IV) had suboptimal cytoreduction. The median survival for Stage IIIC and IV disease was 6.7 months for patients with suboptimal cytoreduction and 17.8 months for patients with optimal cytoreduction (P = 0.001). The proportion of patients with major postoperative complications (37.50% vs. 7.25%, P = 0.005), unplanned postoperative SICU admissions (31.25% vs. 7.25%, P = 0.018), and length of hospital stay exceeding 15 days (31.25% vs. 4.35%, P = 0.005) was greater in patients with suboptimal cytoreductive surgery. CONCLUSIONS: Overall survival is lower and morbidity is higher in patients with advanced endometrial carcinoma having suboptimal cytoreduction at the time of primary surgery. Patients with suspected advanced stage endometrial carcinoma should be counseled on the potential benefits of optimal cytoreductive surgery. Alternative treatment options should be considered in those patients with surgically unresectable disease.     

Clear cell carcinoma of the ovary: a clinicopathologic analysis of 34 cases

Abstract. The clinical and pathologic aspects of 34 cases of pure clear cell carcinoma of the ovary are discussed. These tumors represented 12.1% (34/280) of all ovarian cancers. The ages of the patients ranged from 34 to 78 years (mean 51.6 years) and 59% were postmenopausal. The clinical stages (FIGO) of these patients were as follows; I 22, II 5, III 6, and IV 1. Thirty-nine percent of the patients were nulligravidas. The diameters of the tumor varied from 6 to 31 cm (mean 16 cm), and 47% of the patients had endometriosis. Thirteen tumors were directly connected with endometriosis and this suggests that some ovarian clear cell carcinoma arose from the epithelium of an endometriotic cyst. Three architectural patterns (solid, papillary, and tubulocystic) were recognized. Forty-seven percent of the tumors were predominantly papillary and 24% contained mixtures of these three patterns. Four cell types such as clear, hobnail, eosinophilic, and flattened were also seen. Thirty-eight percent of the tumors had psammoma bodies. Histological patterns and cell types were not prognostic factors, and the stage at presentation was the most important prognostic factor. The 5-year survival rate was 54% (7/13) which was better than that in patients with serous adenocarcinoma of the ovary. The estimated survivals in patients with clear cell carcinoma however, were worse than those in patients with serous adenocarcinoma when compared stage for stage.     

Clinical behavior of stage II-IV low-grade serous carcinoma of the ovary

OBJECTIVE: To analyze the clinical behavior of patients with stage II-IV low-grade serous carcinoma of the ovary seen at our institution who underwent primary surgery followed by platinum-based chemotherapy. METHODS: Patients with stage II-IV low-grade serous carcinoma of the ovary from 1978 to 2003 were identified using existing databases. Clinicopathologic information was obtained from medical records. Progression-free survival and overall survival were estimated by the method of Kaplan and Meier. The log-rank test was used to compare differences between survival curves. Univariable and multivariable analyses were performed using Cox proportional hazards regression. RESULTS: We identified 112 eligible patients. Median age was 43 years.; 90% had stage III disease. Preoperative serum CA 125 was elevated in 86% of patients. The most common sites of extraovarian disease were omentum, fallopian tubes, pelvic peritoneum, and uterus. Response rate to platinum-based chemotherapy in 10 evaluable patients (15% of patients with gross residual disease) was 80%, and 42 patients underwent second-look surgery: microscopically negative findings, 2 (5%); microscopically positive disease, 13 (33%); macroscopically positive disease, 24 (62%); and insufficient information, 3 (7%). Median progression-free survival and overall survival times were 19.5 and 81.8 months. Persistent disease after primary chemotherapy was the only factor associated with shorter overall survival time (hazard ratio 3.46, 95% confidence interval 2.00-5.97, P<.001). CONCLUSION: Metastatic low-grade serous carcinoma of the ovary is characterized by young age at diagnosis and prolonged overall survival. Segregating women with this diagnosis in future clinical trials is warranted.     

化疗对晚期卵巢、输卵管及腹膜浆液性癌淋巴结转移的临床疗效(附70例临床分析)

目的:探讨化疗对晚期卵巢、输卵管及腹膜浆液性癌腹膜后淋巴结转移的临床疗效。方法:将晚期卵巢、输卵管及腹膜浆液性癌70例患者,根据淋巴结切除术与化疗的先后顺序分为2组:A组21例,化疗后行淋巴结切除术。B组49例,淋巴结切除术后化疗。比较2组患者的一般情况、治疗方案及淋巴结转移情况。结果:2组患者的年龄,肿瘤分期分级,治疗前的肿瘤标记物,切除淋巴结的数量等均无显著性差异(P>0.05)。初治时A组患者盆腹腔黏连及转移重于B组;初次手术A组进行满意的肿瘤细胞减灭术的几率明显低于B组(0%vs73.47%,P<0.05)。化疗后A组患者淋巴结转移率低于B组(38.10%vs49.00%,P>0.05),腹主动脉旁淋巴结为肿瘤最常侵犯的淋巴结。A组行TC(泰素/紫杉醇+伯尔定/卡铂)或TP(泰素/紫杉醇+顺铂)方案化疗的患者淋巴转移率低于行CAP(顺铂+阿霉素+环磷酰胺)方案的患者(33.33%vs50%,P=0.045)。结论:化疗对卵巢、输卵管及腹膜浆液性癌淋巴结转移有一定的疗效。初治时不能进行淋巴结切除的患者可考虑先行化疗后再次手术切除淋巴结。     

CAP方案治疗卵巢上皮性癌127例远期疗效分析

目的 :评价接受CAP方案 (环磷酰胺、卡铂 /顺铂、阿霉素 )治疗卵巢上皮性癌 12 7例的远期疗效。方法 :回顾分析 12 7例手术及病理证实的卵巢上皮性癌I～IV期患者手术后接受CAP方案化疗的疗效。比较各期、各病理类型患者术后复发率及生存率。结果 :Ia、Ib～c、II、III期患者术后 8年生存率分别为 10 0 %、87.9%、36 .1%、34.8% ;复发率分别为 4 3.5 %、32 .1%、81.9%、89.2 %。IV期患者 4年生存率为 2 7.0 % ,复发率为10 0 %。II～IV期卵巢透明细胞癌术后 1年生存率为 15 .6 % ,与浆液性、粘液性和内膜样卵巢腺癌 89.2 %的 1年生存率相比差异有显著性 (P =0 .0 10 8)。结论 :CAP方案仍可作为卵巢上皮性癌常规治疗的方案 ,但对透明细胞癌、铂类治疗后复发性癌及IV期卵巢上皮性癌效果不佳     

Pure-type clear cell carcinoma of the ovary as a distinct histological type and improved survival in patients treated with paclitaxel-platinum-based chemotherapy in pure-type advanced disease

OBJECTIVE: The aim was to compare survival in pure and mixed-type advanced clear cell ovarian carcinoma and to determine the benefits among patients with pure advanced clear cell ovarian carcinoma treated in paclitaxel-platinum-based chemotherapy in comparison with those treated in conventional platinum-based chemotherapy after primary surgery. METHODS: Between 1994 and 2001, 31 women with stage III and IV pure clear cell ovarian carcinoma and nine patients with stage III and IV mixed-type clear cell carcinoma were identified from the tumor registry of six institutions. All patients underwent cytoreductive surgery followed by conventional platinum-based chemotherapy or paclitaxel and platinum-based chemotherapy. RESULTS: The median survival of women with pure clear cell carcinoma was 11 months, compared to 48+ months for those with mixed-type clear cell carcinoma (P = 0.003). Overall, for women with pure clear cell carcinoma, 35% had clinically complete responses to chemotherapy. For women with pure clear cell carcinoma treated with paclitaxel-platinum-based chemotherapy, the median survival was significantly longer than for those treated with conventional platinum-based chemotherapy (16.26 vs. 10.75 months, P = 0.045; with optimal cytoreduction, 40.95 vs. 9.02 months, P = 0.028). Univariate analysis showed paclitaxel-platinum-based treatment was the only favorable prognostic factor for women with advanced pure clear cell ovarian carcinoma (P = 0.05). CONCLUSIONS: Patients with advanced pure clear cell ovarian carcinoma have poorer prognoses than those with the mixed type. Paclitaxel-platinum-based chemotherapy improved survival among our patients with advanced pure clear cell carcinoma, especially for those with optimal cytoreduction.     

CA125 regression during neoadjuvant chemotherapy as an independent prognostic factor for survival in patients with advanced ovarian serous adenocarcinoma

OBJECTIVE: The associations of the CA125 regression rate with initial response to chemotherapy and prognosis remain unclear. We examined the association between CA125 regression in neoadjuvant chemotherapy (NAC) and prognosis. METHODS: Fifty patients with advanced ovarian cancer (TNM classification TIIIc or M1) who received initial NAC and did not undergo significant cytoreductive surgery were selected for the retrospective analysis, after excluding clear cell carcinoma and mucinous adenocarcinoma putative to be cisplatin-resistant. For each patient, regression coefficient was calculated using all the CA125 levels measured from the day of NAC as day 0 until the day of normalization of CA125 level (<35 IU/ml) or the day of standard surgery. Responder was defined as a regression coefficient of -0.039 or greater (33 cases) and nonresponder as a regression coefficient less than -0.039 (17 cases). RESULTS: The 3-year survival rate for all 50 cases was 59.3%. When stratified by regression coefficient of CA125 levels, the 3-year survival was 70.5% in responders and 43.3% in nonresponders. Univariate analysis identified the regression coefficient of CA125 as a significant prognostic factor for overall survival (P = 0.012; log lank test). Residual tumor at standard surgery after NAC and absolute CA125 level were not significant prognostic factors. CONCLUSIONS: Based on the CA125 regression rate, it is possible to stratify TIIIc or M1 ovarian serous adenocarcinoma cases into those with a good prognosis of survival and those with poor prognosis. Regression coefficient of CA125 level greater than -0.039 predicts good 3-year survival after subsequent radical surgeries.     

12例腹膜原发性浆液性乳头状癌临床诊治分析

目的探讨腹膜原发性浆液性乳头状癌的临床特点、诊断标准、治疗方法和预后。方法对1997年1月-2004年12月在我院经病理确诊为腹膜原发性浆液性乳头状癌的12例患者的临床资料进行回顾性分析。结果所有患者均行肿瘤细胞减灭术，术后施以铂类为主的化疗方案。生存期大约20个月的患者均接受6次以上化疗，术前接受化疗的患者的平均生存期大于28．3个月，较术前未行化疗者生存期长。结论腹膜原发性浆液性乳头状癌是一种起病隐袭，发病率较低的恶性肿瘤，易被误诊。明确的诊断、术前化疗、手术的彻底性及术后足量的化疗可以延长患者的生存期。CA125可作为诊断及监测预后的指标之一。