Ghaemmaghami Fatemeh, Karimi-Zarchi Mojgan, Modares-Gilani Mitra, Mousavi Azamsadat, Behtash Nadereh
Gynecologic Oncology Department, Vali-e-Asr Hospital, Imam Khomeini Oncology Complex, Medical Sciences/Tehran University, Tehran, Iran.
Asian Pac J Cancer Prev. 2008 Oct-Dec;9(4):719-24.
The aim of this study is to evaluate the results of neoadjuvant chemotherapy (NACT) and the impact of interval debulking surgery (IDS) on clinical outcomes of patients with advanced-stage ovarian cancer.
We performed a retrospective analysis on 92 patients with advanced ovarian cancer admitted to Vali-Asr Gynecologic oncology departments during 1996-2002. Comparison was made with results of neoadjuvant chemotherapy of 24 patients with unresectable advanced epithelial ovarian cancer treated with platinum- based NACT followed by IDS and clinical outcomes of 68 consecutive stage III and IV ovarian cancer patients treated with primary cytoreduction followed by platinum-based adjuvant chemotherapy.
Primary cytoreductive surgery caused longer survival compared to neoadjuvant chemotherapy. Patients who underwent optimal interval debulking surgery (IDS) had a better progression free survival (PFS) (p=0.002) and overall survival (p=0.03) than those who did not. There were not significant differences between the two groups in complications of surgery.
NACT followed by successful IDS can lead to high survival percentage in patients with chemoresponsive advanced ovarian cancer; although the result is more effective in those with optimal primary cytoreduction, we still got the same results with those with suboptimal primary cytoreduction.
本研究旨在评估新辅助化疗（NACT）的效果以及间隔减瘤手术（IDS）对晚期卵巢癌患者临床结局的影响。
我们对1996年至2002年间入住瓦利 - 阿斯尔妇科肿瘤科室的92例晚期卵巢癌患者进行了回顾性分析。将其与24例不可切除的晚期上皮性卵巢癌患者接受铂类新辅助化疗后行间隔减瘤手术的新辅助化疗结果，以及68例连续的III期和IV期卵巢癌患者接受初次肿瘤细胞减灭术继以铂类辅助化疗的临床结局进行比较。
与新辅助化疗相比，初次肿瘤细胞减灭术可带来更长的生存期。接受最佳间隔减瘤手术（IDS）的患者比未接受该手术的患者具有更好的无进展生存期（PFS）（p = 0.002）和总生存期（p = 0.03）。两组手术并发症之间无显著差异。
新辅助化疗后成功进行间隔减瘤手术可使化疗敏感的晚期卵巢癌患者获得较高的生存率；尽管在初次肿瘤细胞减灭术最佳的患者中结果更有效，但我们在初次肿瘤细胞减灭术欠佳的患者中也得到了相同的结果。
