晚期卵巢上皮癌初治方案选择的预测因素

目的探讨晚期卵巢上皮癌初治方案选择的预测因素。方法根据初治方案将120例晚期卵巢上皮癌患者分为先行手术组（78例）和先期化疗再间期手术组（简称：先期化疗组）（42例），分析了影响初次手术成功率的因素以及先期化疗对间期手术成功的作用。采用Logistic回归方法，用Log-rank和Kaplan-Meier方法分析生存率。结果先行手术组的手术成功率为46．2％（36／78），先期化疗组的手术成功率为59．5％（25／42）。研究表明降低初次手术成功率的因素有腹水、CA125〉500U／L、道格拉斯窝异常。有腹水及CA125〉500U／L的患者经先期化疗后的间期手术成功率高于初次手术（P〈0．05）。结论对晚期卵巢上皮癌在选择治疗方案前分析预测因素是有益的。它有助于筛选出宜初次手术和以先期化疗为最佳初次治疗方案的病例。

Predictive Factors for Initial Treatment of Advanced Epithelial Ovarian Cancer

Objective This study was designed to explore the predictive factors for initial treatment of advanced epithelial ovarian cancer.Methods A retrospective study was conducted based on 120 advanced epithelial ovarian cancer.These patients were studied in initial surgery group(78 cases) and primary chemotherapy group(42 cases).We analyzed the factors that might be related to the success of the initial surgery and the influence of primary chemotherapy on the success of the surgery respectively.Logistic regression model was used in the retrospective study,the survival was analyzed by log-rank and Kaplan-Meier test.Results The successful rate of the surgery in the initial surgery group and primary chemotherapy group were 46.2% and 59.5% respectively.The variables associated with a lesser probability of success in the study are the presence of ascites,elevation of CA125 above 500 U/L and the abnormal presence in Douglas'cul-de-sac.Primary chemotherapy decreased the first two influences on the success of the surgery.Conclusion The predictive factors analysis before initial treatment might be of benefit to the advanced epithelial ovarian cancer.It is considered a useful tool to identify susceptible case of a successful initial surgery and those in which the primary chemotherapy would be the best initial treatment.