Ho Chih-Ming, Chien Tsai-Yen, Shih Bor-Yuan, Huang Shih-Hung
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital, 106, Taipei, Taiwan.
Gynecol Oncol. 2003 Mar;88(3):394-9. doi: 10.1016/s0090-8258(02)00156-7.
The aim was to determine the benefits of lymphadenectomy and paclitaxel plus carboplatin chemotherapy for stage I ovarian clear cell carcinoma (defined as intra-abdominal disease confined to the ovaries).
Twenty patients with stage I pure clear cell carcinoma of the ovary diagnosed between 1991 and 2001 were divided into two groups: Group A (12 patients, 1997-2001) underwent complete surgical staging including bilateral salpingo-oophorectomy, hysterectomy, omentectomy, and pelvic and para-aortic lymphadenectomy, followed by paclitaxel and carboplatin chemotherapy. Group B (8 patients, 1991-1996) underwent bilateral salpingo-oophorectomy, hysterectomy, and omentectomy without lymphadenectomy, followed by cisplatin-based chemotherapy. The survival of the two groups was compared. The clinical characteristics of the two groups were evaluated for age distribution, grade, substage, preoperative CA-125, presence or absence of endometriosis, and maximal tumor diameter.
The estimated 4-year survival rate was 76.9%. The clinical characteristics of the two groups were similar, except for lymphadenectomy and regimen of chemotherapy. With a median follow-up of 36 months (range: 11-130 months), one of 12 patients in Group A had recurrence in comparison with 6 of 8 patients in Group B (P = 0.004). The estimated 3-year recurrence-free survival and 4-year overall survival for Group A was significantly greater than that for Group B (91.7 vs 33.3%, P = 0.014; 100 vs 50%, P = 0.014). Median time to recurrence was 8 months.
Complete surgical staging, including pelvic and para-aortic lymphadenectomy and paclitaxel plus carboplatin chemotherapy, appeared to be capable of improving survival of patients with stage I ovarian clear cell carcinoma.
旨在确定淋巴结切除术以及紫杉醇联合卡铂化疗对Ⅰ期卵巢透明细胞癌（定义为局限于卵巢的腹腔内疾病）的益处。
将1991年至2001年间确诊的20例Ⅰ期卵巢纯透明细胞癌患者分为两组：A组（12例患者，1997 - 2001年）接受了包括双侧输卵管卵巢切除术、子宫切除术、大网膜切除术以及盆腔和腹主动脉旁淋巴结切除术在内的完整手术分期，随后接受紫杉醇和卡铂化疗。B组（8例患者，1991 - 1996年）接受了双侧输卵管卵巢切除术、子宫切除术和大网膜切除术，但未进行淋巴结切除术，随后接受以顺铂为基础的化疗。比较两组的生存率。评估两组的临床特征，包括年龄分布、分级、亚分期、术前CA - 125、子宫内膜异位症的有无以及最大肿瘤直径。
估计4年生存率为76.9%。两组的临床特征相似，除了淋巴结切除术和化疗方案。中位随访时间为36个月（范围：11 - 130个月），A组12例患者中有1例复发，而B组8例患者中有6例复发（P = 0.004）。A组的估计3年无复发生存率和4年总生存率显著高于B组（91.7%对33.3%，P = 0.014；100%对50%，P = 0.014）。复发的中位时间为8个月。
包括盆腔和腹主动脉旁淋巴结切除术以及紫杉醇联合卡铂化疗在内的完整手术分期似乎能够提高Ⅰ期卵巢透明细胞癌患者的生存率。
