摘要
背景与目的:中晚期上皮性卵巢癌复发率较高,生存率低。在没有可靠的早期诊断技术的情况下,了解其复发的影响因素对于预后的判断和指导治疗具有非常重要的意义。本文旨在探讨上皮性卵巢癌复发的影响因素。方法:109例上皮性卵巢癌,对可能导致病人复发的影响因素:年龄,病理类型,临床分期,新辅助化疗,术后化疗方案和化疗疗程,初次手术治疗情况;以及手术残留癌灶大小,用Logistic回归方法进行回顾性总结和分析。结果:109例患者中复发36例,复发率为33.0％,中位复发时间19个月;109例病人总的5年生存率为62.7％,复发病人5年生存率43.3％;盆腔复发病人的5年生存率为50.1％,盆腔外复发病人的5年生存率36.1％,二者相比较无统计学意义(P>0.05)。单因素分析分别显示粘液性腺癌和临床分期为Ⅰ期的复发风险较低(回归系数β=1.565和-1.799,P=0.0120和0.026);而化疗疗程>8个疗程的病人复发风险明显高于1～4疗程和6～8疗程 的病人(回归系数β=-3.591和-1.500,P<0.001和=0.038)。多因素分析显示病理类型、临床分期和术后化疗疗程数是影响卵巢癌治疗后复发的独立危险因素(RR=3.473,4.713和6.140,P<0.05)。结论:临床分期是影响复发的显著因素,早期诊断对于降低卵巢癌复发率十分重要。合理的化疗计划对于卵巢癌的治疗是必要的,?
BACKGROUND & OBJECTIVE: Advanced ovarian cancer shows a high recurrence and poor survival rate. It is important to identify the risk factors for the recurrence of ovarian cancer, due to the lack of reliable methods for the detection of early disease. This study was designed to explore the risk factors for the recurrence of epithelial ovarian cancer. METHODS: Factors that might be related to the recurrence of 109 epithelial ovarian cancer patients including age, pathological type, FIGO stage, operation type, chemotherapy regimen, neoadjuvant chemotherapy, postoperative chemotherapy cycles, first operation status, and size of residual tumor were analyzed by logistic regression model using SPSS 10.0 statistical software. RESULTS: Of 109 patients with ovarian cancer, 36 (33% ) relapsed after a combination of surgery and chemotherapy, and the median recurrence-free interval was 19 months. The 5-year survival rates were 62.7% and 43.3% for the 109 patients and the recurrent patients, respectively. The survival rates of pelvic recurrence (50.1 % ) and extra-pelvic recurrence (36.1% ) were not statistically different. Univariate analysis showed that the risk of recurrence in mucous adenocarcinoma or FIGO stage I patients were lower than that of other pathology type or FIGO stage (p = -1. 565 and -1. 799, P =0. 0120 and 0. 026 ) while it was higher in the patients given above 8 cycles chemotherapy than those given 1 -4 or 6 -8 cycles(p = -3. 591 and -1. 500, P <0. 001 and =0. 038). Multivariate analysis showed that histological type, FIGO stage and postoperative chemotherapy cycles had remarkable influence on the relapse of epithelial ovarian cancer independently(RR =3. 473, 4.713, and 6. 140, respectively, P <0. 05). CONCLUSION: Histological type, FIGO stage, and postoperative chemotherapy cycles influence the recurrence of epithelial ovarian cancer. Since FIGO stage is a remarkable risk factor for the recurrence, early diagnosis should be the key point to decrease it. Reasonable chemotherapy plan is essential for the therapy of ovarian cancer, but excessive chemotherapy is not good for effectiveness.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2003年第11期1197-1200,共4页
Chinese Journal of Cancer
