Gultekin Murat, Dursun Polat, Doğan Nasuh U, Kolusari Ali, Yuce Kunter, Ayhan Ali
Hacettepe University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Sihhiye, Ankara, Turkey.
J Surg Oncol. 2009 Sep 1;100(3):258-60. doi: 10.1002/jso.21274.
There is still no any data about the role of re-operation and re-debulking in previously incompletely operated advanced staged patients with epithelial ovarian carcinoma (EOC). In this study, the authors aimed to analyze the effect of an incomplete primary surgery on patient prognosis.
Clinicopathological variables of 317 advanced staged EOC patients were retrospectively collected.
Twenty-nine patients had an initial incomplete surgery and referred to our center for debulking while remaining 288 had undergone primary debulking surgery at our institution. Comparison of the two groups with respect to clinicopathological variables could not reveal significant difference. Median survival was 3.24 years for re-operated patients while it was 2.07 years for patients who had undergone primary debulking surgery. Upon multivariate analysis, final optimal debulking, tumor grade and a history of an incomplete surgery before the final debulking were the significant prognosticators. A subgroup analysis of re-staged patients could not reveal a significant role for either the type or the time interval between the operations.
A history of an incomplete primary surgery does not seem to adversely affect patient prognosis and the optimal cytoreductive success achieved in final debulking surgery is still the most important prognostic factor.
对于先前手术未完全切除的晚期上皮性卵巢癌（EOC）患者，再次手术及再次减瘤的作用尚无相关数据。在本研究中，作者旨在分析初次手术不彻底对患者预后的影响。
回顾性收集317例晚期EOC患者的临床病理变量。
29例患者初次手术未彻底切除，转诊至本中心进行减瘤手术，其余288例患者在本机构接受了初次减瘤手术。两组患者临床病理变量比较未显示出显著差异。再次手术患者的中位生存期为3.24年，而接受初次减瘤手术的患者为2.07年。多因素分析显示，最终最佳减瘤、肿瘤分级以及最终减瘤前手术不彻底的病史是显著的预后因素。对再次分期患者的亚组分析未显示出手术类型或手术间隔时间的显著作用。
初次手术不彻底的病史似乎不会对患者预后产生不利影响，最终减瘤手术中实现的最佳细胞减灭效果仍是最重要的预后因素。
