复发卵巢上皮性癌的治疗与预后分析

Objective To discuss the prognostic factors of recurrent ovarian epithelial carcinoma and to analyze the curative effect of post-relapse treatment.Methods The clinical records of 293 patients with ovarian epithelial carcinoma were reviewed retrospectively.There were 199 recurrent cases during the following up.Results All the 199 patients received chemotherapy.And 173 patients only received chemotherapy.16 patients received surgery and chemotherapy and the other 10 patients received radiotherapy and chemotherapy.158 patients received platinum-based chemotherapy again and 41 patients received chemotherapy without platinum.The response rate of all the patients was 43.7%(87/199),the response rate of only chemotherapy was 39.9%(69/173),the response rate of surgery and chemotherapy was 75.0%(12/16),and the response rate of radiotherapy and chemotherapy was 60.0%(6/10).The patients were divided into four groups according to the progression free interval(PFI).The response rates in groups that PFI ≤6 months,7-12 months,13-24 months and ＞24 months were 5.1%,47.2%,82.1% and 96.0%,respectively.The median survival time in the 16 patients received second cyto-reductive surgery was 41 months.Multivariate analysis revealed that PFI was significantly correlated with prognosis of recurrent ovarian epithelial carcinoma(OR =0.589,P =0.021).Conclusion PFI is an individual prognostic factor for survival of recurrent ovarian epithelial carcinoma.PFI is significantly associated with the response rate of chemotherapy.Optimal secondary cytoreductive surgery may improve the overall survival of recurrent patients.The response rate of paclitaxel plus platinum chemotherapy in platinum-sensitive patients is higher than that of other platinum-based chemotherapy.

Analysis of treatment and prognosis of recurrent epithelial ovarian carcinoma