Zhao Jing-zhu, Wang Gang, Zhang Ru-peng, Liang Han
Department of Gastric Cancer, Key Lab of Cancer Treatment and Prevention, Cancer Hospital, Tianjin Medical University, Tianjin, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Feb;13(2):129-32.
To investigate the clinicopathological features and prognosis of metastatic ovarian tumors from gastric cancer.
Clinical data of 68 patients with metastatic ovarian carcinoma were reviewed retrospectively.
The median age was 46 years. The majority of these patients was in the premenopausal state (67.6%) and had bilateral ovarian involvement (64.7%). Pathological type was signet-ring cell carcinoma in 52.9% of the cases. Most of them underwent surgical treatment or chemotherapy or both. The median overall survival was 14.1 months, and the median progression-free survival was 6.7 months. The survival rates in 1-, 3- and 5-year were 54.8%, 14.9% and 0, respectively. Univariable analysis revealed that resection of gastric cancer, lymphatic metastasis, pathologic type of metastatic ovarian tumor, extent of metastatic lesion, cytoreductive surgery and chemotherapy for metastatic ovarian carcinoma were associated with the prognosis. Multivariable analysis revealed that cytoreductive surgery and extent of metastatic lesion were independent factors. Patients with metastatic lesion confined to the ovaries had a median overall survival of 16.0 months as compared to 8.6 months for those with more extensive metastases (P<0.01), and had a median progression-free survival of 8.2 months as compared to 4.1 months for those with more extensive metastases (P<0.05). Patients who underwent optimal cytoreduction(residual lesion < or =2 cm) had a median overall survival of 16.0 months as compared to 9.7 months for those who received suboptimal cytoreduction (residual lesion >2 cm) ( P<0.01). Optimal cytoreduction was also associated with a significantly longer median progression-free survival (11.0 months) as compared to suboptimal cytoreduction median progression-free survival (3.1 months) (P<0.01).
Prognosis of patients with metastatic ovarian carcinoma from gastric cancer is quite poor. Extent of metastatic lesion is an independent factor. Optimal cytoreduction is associated with improved survival.
探讨胃癌转移性卵巢肿瘤的临床病理特征及预后。
回顾性分析68例转移性卵巢癌患者的临床资料。
中位年龄为46岁。这些患者大多数处于绝经前状态（67.6%），双侧卵巢受累（64.7%）。52.9%的病例病理类型为印戒细胞癌。大多数患者接受了手术治疗或化疗或两者皆有。中位总生存期为14.1个月，中位无进展生存期为6.7个月。1年、3年和5年生存率分别为54.8%、14.9%和0。单因素分析显示，胃癌切除、淋巴结转移、转移性卵巢肿瘤的病理类型、转移灶范围、细胞减灭术及转移性卵巢癌化疗与预后相关。多因素分析显示，细胞减灭术和转移灶范围是独立因素。转移灶局限于卵巢的患者中位总生存期为16.0个月，而转移范围更广的患者为8.6个月（P<0.01），转移灶局限于卵巢的患者中位无进展生存期为8.2个月，而转移范围更广的患者为4.1个月（P<0.05）。接受最佳细胞减灭术（残留病灶≤2 cm）的患者中位总生存期为16.0个月，而接受次优细胞减灭术（残留病灶>2 cm）的患者为9.7个月（P<0.01）。与次优细胞减灭术的中位无进展生存期（3.1个月）相比，最佳细胞减灭术也与显著更长的中位无进展生存期（11.0个月）相关（P<0.01）。
胃癌转移性卵巢癌患者的预后相当差。转移灶范围是一个独立因素。最佳细胞减灭术与生存率提高相关。
