Ramirez Pedro T, Slomovitz Brian M, McQuinn Lacey, Levenback Charles, Coleman Robert L
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, PO Box 301439, Unit 1362, Houston, TX 77230-1439, USA.
Gynecol Oncol. 2006 Dec;103(3):888-90. doi: 10.1016/j.ygyno.2006.05.021. Epub 2006 Jun 27.
To determine whether appendectomy is warranted in patients with apparent early-stage ovarian cancer who undergo surgery for staging and cytoreduction and to determine the complication rate associated with appendectomy in such patients.
We reviewed the medical records of all patients who underwent appendectomy at the time of primary surgery for ovarian cancer at The University of Texas M. D. Anderson Cancer Center between January 1992 and December 2004 and who did not meet any of the following exclusion criteria: stage III or IV ovarian cancer, appendectomy as part of a second-look procedure or secondary tumor-reductive surgery, primary appendiceal cancer, primary gastrointestinal malignancy with metastasis to the appendix, incomplete clinicopathologic data, appendicitis as a preoperative diagnosis, primary fallopian tube cancer, primary peritoneal cancer, or documented dual primary tumors.
Fifty-seven patients were included in this analysis. The median age was 47 years (range, 13-75). Median follow-up was 53 months (range, 3-147). Histologic diagnoses were as follows: invasive epithelial carcinoma, 35 patients (61%); tumor of low malignant potential, 15 patients (26%); malignant germ cell tumor, 4 patients (7%); and other, 3 patients (5%). Twenty-three patients (40%) had pure mucinous tumors. Forty-six patients (81%) had stage I and 11 patients (19%) had stage II disease. The median CA-125 level was 36.2 U/mL (range, 7-7900). No patient had evidence of appendiceal involvement. No patient suffered an intraoperative or postoperative complication directly related to appendectomy.
Appendectomy at the time of surgery for apparent early-stage ovarian cancer is not associated with complications but should not be routinely recommended.
确定对于接受分期及肿瘤细胞减灭术的疑似早期卵巢癌患者，阑尾切除术是否必要，并确定此类患者阑尾切除术的并发症发生率。
我们回顾了1992年1月至2004年12月在德克萨斯大学MD安德森癌症中心因卵巢癌初次手术时接受阑尾切除术且不符合以下任何排除标准的所有患者的病历：III期或IV期卵巢癌、作为二次探查手术或二次肿瘤细胞减灭术一部分的阑尾切除术、原发性阑尾癌、伴有阑尾转移的原发性胃肠道恶性肿瘤、不完整的临床病理数据、术前诊断为阑尾炎、原发性输卵管癌、原发性腹膜癌或已记录的双原发性肿瘤。
57例患者纳入本分析。中位年龄为47岁（范围13 - 75岁）。中位随访时间为53个月（范围3 - 147个月）。组织学诊断如下：浸润性上皮癌35例（61%）；低恶性潜能肿瘤15例（26%）；恶性生殖细胞肿瘤4例（7%）；其他3例（5%）。23例（40%）有纯黏液性肿瘤。46例（81%）为I期疾病，11例（19%）为II期疾病。CA - 125中位水平为36.2 U/mL（范围7 - 7900）。无患者有阑尾受累证据。无患者发生与阑尾切除术直接相关的术中或术后并发症。
对于疑似早期卵巢癌患者，手术时行阑尾切除术虽无并发症，但不应常规推荐。
