Division of Gynecologic Oncology, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Int J Gynecol Cancer. 2010 Jan;20 Suppl 1:S1-11. doi: 10.1111/IGC.0b013e3181cff38b.
Ovarian cancer is the leading cause of gynecologic cancer-related mortality in the United States. Surgical cytoreduction is the cornerstone of current treatment in patients with advanced disease, but it offers the best chances for overall survival when optimal cytoreduction is achieved. Clinicopathological and radiological models for predicting optimal resectability have not been universally applicable.
To summarize the existing surgical data on current serologic, radiological, and surgical tools used to predict the resectability of advanced ovarian cancer.
Systematic review of surgical studies on primary cytoreductive surgery for advanced ovarian cancer reported in the English-language literature between 1980 and 2009.
Seventeen retrospective studies using cancer antigen 125, and 8 retrospective studies using radiological imaging modalities to predict resectability of advanced ovarian cancer were reviewed. Five laparoscopic-based reports of ovarian cancer resectability were also reviewed as well as 5 studies examining the role of clinicopathological variables affecting surgical cytoreductive ability. These studies were analyzed according to the rate of optimal cytoreduction achieved and the reported sensitivity, specificity, accuracy, and predictive values of predictive parameters described. Finally, the various conclusions were compared.
The rates of optimal cytoreduction vary among surgeons. A universally applicable clinical model that can predict which patients will undergo optimal cytoreduction remains elusive. More research is needed to devise a set of uniform criteria that can be used to predict ovarian cancer resectability among different patient populations.
卵巢癌是美国妇科癌症相关死亡的主要原因。在晚期疾病患者中，手术细胞减灭术是当前治疗的基石，但只有在达到最佳细胞减灭术时才能提供最佳的总生存机会。目前还没有普遍适用的预测最佳可切除性的临床病理和影像学模型。
总结目前用于预测晚期卵巢癌可切除性的现有血清学、影像学和手术工具的外科数据。
对 1980 年至 2009 年期间在英文文献中报告的用于治疗晚期卵巢癌的原发性细胞减灭术的外科研究进行系统回顾。
回顾了 17 项使用癌症抗原 125 预测晚期卵巢癌可切除性的回顾性研究，以及 8 项使用影像学检查预测晚期卵巢癌可切除性的回顾性研究。还回顾了 5 项关于卵巢癌可切除性的腹腔镜研究报告，以及 5 项研究探讨了影响手术细胞减灭能力的临床病理变量的作用。根据达到的最佳细胞减灭率以及报告的预测参数的敏感性、特异性、准确性和预测值，对这些研究进行了分析。最后，对各种结论进行了比较。
最佳细胞减灭率因外科医生而异。仍然难以捉摸一种普遍适用的临床模型，可以预测哪些患者将接受最佳细胞减灭术。需要进一步研究来制定一套统一的标准，以便在不同的患者群体中预测卵巢癌的可切除性。
