晚期上皮性卵巢癌肠肿瘤切除的作用

目的：分析晚期上皮性卵巢癌行肿瘤细胞减灭术时肠道转移瘤行肠道肿瘤切除的临床应用。方法：回顾性分析1998～2003年52例晚期上皮性卵巢癌行肿瘤细胞减灭术时肠道转移瘤行肠道肿瘤切除的患者，与同期未行肠道肿瘤切除的仅行姑息性手术的16例患者进行比较，采用统计学方法进行处理。结果：68例手术治疗患者中，52例完成肠道肿瘤切除手术，其中34例无肉眼呵见残余肿瘤，8例残余肿瘤〈1cm，10例残余肿瘤〉1cm，其中位生存期分别为28个月、23个月和13个月，16例因肿瘤广泛转移未行肠道肿瘤切除仅行姑息性手术的患者中位生存期为7．66个月，肠道肿瘤广泛转移及肠系膜根部广泛种植是手术失败的关键。结论：晚期上皮性卵巢癌行肿瘤细胞减灭术时行肠道转移瘤切除，达到满意手术效果时对生存期提高足有帮助的，而选择恰当的患者是手术治疗的关键。

The role of bowel tumor resection for patients with advanced epithelial ovarian carcinoma

Objective:Advanced ovarian epithelial carcinoma frequently metastasizes to the bowel. We intestigated whether cytoreductive surgery including bowel resection would affect the survival of these patients.Methods:We retrospectively reviewed 52 patients underwent cytoreductive surgery with bowel resection due to advanced ovarian carcinoma and 16 patients receiving palliative surgery from 1998 to 2003.Results:During the study period,52 bowel resection were performed on 68 patients.Among them,the median survival rates according to the amount of residual tumor were 29 months for 34 patients with no macroscopic residual disease,23 months for 8 patients with residual disease less than 1cm and 13 months for 10 patients with residual disease more than 1cm.The median survival rates were 7.65 months for 16 patients who performed palliative surgery due to tumor widely spread itself. The main reason led to operation failed were widely metastases to bowel and the root of mesentery.Conclusion:Cytoreductive surgery with bowel tumor resection should be considered for ovarian carcinoma patients to help ensure that they are left no residual disease after debulking surgery,and properly selected patients are the key to its success.