Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France.
Int J Gynecol Cancer. 2010 Apr;20(3):346-52. doi: 10.1111/IGC.0b013e3181d1897e.
To determine the impact of secondary surgery in patients treated for a serous low malignant potential ovarian tumor (LMPOT) and peritoneal implants.
A retrospective review of patients with a serous LMPOT and peritoneal implants treated in or referred to our institution. The characteristics of patients who had undergone surgery were compared with those who had not. We analyzed the clinical impact of this procedure.
From 1969 to 2006, 171 patients were reviewed. Secondary surgery was defined as classic second-look surgery (residual disease at the time of initial surgery, a different histological analysis between the initial and definitive diagnosis) and surgery for abnormal radiological findings during follow-up. Fifty-seven patients had undergone secondary surgery (which was positive in 16 of them). The percentages of patients with residual disease and invasive implants at the time of initial management who had received adjuvant therapy were higher among subjects who had undergone secondary surgery. The recurrence-free interval between patients in whom secondary surgery was negative and in patients who had not undergone a secondary procedure was statistically different. Four factors were predictive of recurrent disease: the use of conservative surgery, the use of laparoscopic surgery, the presence of residual disease at the end of surgery, and positive secondary surgery.
Secondary surgery seems to reduce the risk of recurrence in patients with serous LMPOT and peritoneal implants. Patients with residual disease are probably those likely to benefit from such surgery. Further studies are needed to confirm these preliminary results.
确定二次手术对治疗浆液性低度恶性潜能卵巢肿瘤（LMPOT）和腹膜种植瘤患者的影响。
对在我院治疗或转诊的浆液性 LMPOT 和腹膜种植瘤患者进行回顾性研究。比较接受手术治疗和未接受手术治疗患者的特征。分析该手术的临床影响。
1969 年至 2006 年，共回顾性分析了 171 例患者。二次手术定义为经典二次探查术（初次手术时存在残留病灶，初始诊断和最终诊断的组织学分析不同）和随访期间影像学异常的手术。57 例患者接受了二次手术（其中 16 例为阳性）。在初次治疗时接受辅助治疗的残留病灶和侵袭性种植瘤患者比例在接受二次手术的患者中更高。二次手术阴性的患者和未行二次手术的患者之间的无复发生存期有统计学差异。有四个因素与疾病复发相关：采用保守性手术、采用腹腔镜手术、手术结束时存在残留病灶和二次手术阳性。
二次手术似乎降低了浆液性 LMPOT 和腹膜种植瘤患者的复发风险。存在残留病灶的患者可能从该手术中获益。需要进一步的研究来证实这些初步结果。
