Benedetti Panici Pierluigi, De Vivo Antonio, Bellati Filippo, Manci Natalina, Perniola Giorgia, Basile Stefano, Muzii Ludovico, Angioli Roberto
Department of Obstetrics and Gynecology, University of Rome La Sapienza, Viale del Policlinico, 155, 00161, Rome, Italy.
Ann Surg Oncol. 2007 Mar;14(3):1136-42. doi: 10.1245/s10434-006-9273-8. Epub 2006 Dec 31.
Secondary surgical cytoreduction (SCR) represents a promising therapeutic strategy for patients affected by ovarian cancer disease recurrence. The aim of this prospective observational trial was to analyze the role of SCR in patients with platinum-sensitive ovarian cancer.
Patients with platinum-sensitive ovarian cancer underwent SCR by a single surgical team. Clinical and oncologic data were prospectively recorded. A total of 47 patients underwent SCR from 1999 to 2003.
The mean operating time was 210 minutes, and mean blood loss was 500 mL. The most frequent surgical procedures carried out were splenectomy, lymphadenectomy, bowel resection, and extensive peritonectomy. Optimal cytoreduction was achieved in 41 patients. Thirty-seven patients had no visible tumor at the end of SCR. Overall median survival was 49 months. Patients who achieved optimal residual disease had a median survival of 61 months, whereas patients who had residual disease >1 cm had a median survival of 19 months.
Positive CA-125 (cancer antigen 125) was identified as a negative prognostic factor at multivariate analysis. After careful selection, optimal cytoreduction can be achieved in most patients who are subjected to SCR with acceptable morbidity. Residual tumor and CA-125 represent the most important prognostic factors.
二次手术细胞减灭术（SCR）是一种对复发性卵巢癌患者有前景的治疗策略。这项前瞻性观察性试验的目的是分析SCR在铂敏感型卵巢癌患者中的作用。
铂敏感型卵巢癌患者由单一手术团队进行SCR。前瞻性记录临床和肿瘤学数据。1999年至2003年共有47例患者接受了SCR。
平均手术时间为210分钟，平均失血量为500毫升。最常进行的手术操作是脾切除术、淋巴结切除术、肠切除术和广泛腹膜切除术。41例患者实现了最佳细胞减灭。37例患者在SCR结束时无可见肿瘤。总体中位生存期为49个月。实现最佳残留病灶的患者中位生存期为61个月，而残留病灶>1厘米的患者中位生存期为19个月。
在多变量分析中，CA-125（癌抗原125）阳性被确定为不良预后因素。经过仔细选择，大多数接受SCR的患者可以实现最佳细胞减灭，且发病率可接受。残留肿瘤和CA-125是最重要的预后因素。
