Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
Arch Gynecol Obstet. 2011 Nov;284(5):1223-9. doi: 10.1007/s00404-010-1750-4. Epub 2010 Dec 4.
The aims of this study were to assess the surgical outcomes and to also determine the prognostic factors in patients with surgically resectable liver metastases for recurrent ovarian cancer.
Between 1991 and 2008, 18 patients with recurrent ovarian cancer who underwent hepatic resection as part of secondary cytoreductive surgery were identified from the tumor registry pathology database. Parameters for safety, efficacy, and survival data were considered as primary endpoints.
Hepatic resections included wedge resection (n = 4), unisegmentectomy (n = 13), and bisegmentectomy (n = 1). There were no surgery-related deaths. Only one patient (5.6%) had postoperative major complications. The median postoperative hospitalization was 15.5 days (range 11-46 days). The prognostic factors associated with improved survival were less abdominal than pelvic disease (38 vs. 11 months, P = 0.032), optimal cytoreduction (40 vs. 9 months, P = 0.0004), and negative margin status of the hepatic resection (40 vs. 9 months, P = 0.0196). The overall median survival after hepatic resection was 38 months (range 3-78 months).
Hepatic resection for recurrent ovarian cancer is safe and is associated with a favorable outcome. Parenchymal liver metastases should not exclude attempts at optimal secondary cytoreductive surgery, and especially, patients with solitary liver metastases should be considered for hepatic resection.
本研究旨在评估手术结果，并确定复发性卵巢癌患者接受可切除肝转移灶手术的预后因素。
1991 年至 2008 年间，从肿瘤登记病理学数据库中确定了 18 例接受肝切除术作为二线减瘤手术一部分的复发性卵巢癌患者。安全性、疗效和生存数据参数被认为是主要终点。
肝切除术包括楔形切除术（n = 4）、单段切除术（n = 13）和双段切除术（n = 1）。无手术相关死亡。仅有 1 例患者（5.6%）发生术后重大并发症。术后中位住院时间为 15.5 天（范围 11-46 天）。与生存改善相关的预后因素是腹部病变少于盆腔病变（38 个月比 11 个月，P = 0.032）、最佳减瘤（40 个月比 9 个月，P = 0.0004）和肝切除术的阴性切缘状态（40 个月比 9 个月，P = 0.0196）。肝切除术后的总体中位生存时间为 38 个月（范围 3-78 个月）。
复发性卵巢癌的肝切除术是安全的，并与良好的结果相关。实质肝转移不应排除尝试最佳二线减瘤手术的可能性，特别是应考虑对单发肝转移灶的肝切除术。
