Chéreau E, Ballester M, Lesieur B, Selle F, Coutant C, Rouzier R, Daraï E
Hôpital Tenon, AP-HP, Paris, France.
Gynecol Obstet Fertil. 2011 Jan;39(1):21-7. doi: 10.1016/j.gyobfe.2010.08.017. Epub 2010 Dec 22.
Treatment of advanced ovarian cancer should include surgery with optimal cytoreduction, which is the first prognosis factor. This surgery usually requires extensive resection (pelvic surgery, extensive lymphadenectomy, upper abdominal surgery and sometimes multiple intestinal resection). The complete surgery usually requires a resection of the diaphragm peritoneum in 10 to 100% of cases, intestinal resection in 20 to 100% of cases, splenectomy in 1 to 33% of cases, pancreatectomy in 0 11% of cases, resection of liver metastases in 0 to 16% of cases and cholecystectomy in 2 to 20% of cases. The main complications reported were digestive fistula (1.4 to 8.2%), lymphocyst (0.6 to 32%), septic complications (3.7 to 41.4%) and pulmonary complications (0 to 59%) in case of diaphragmatic surgery. The postoperative mortality ranges from 0.3 to 5.7%. Radical surgery increases the rate of complete cytoreduction with significant morbidity and postoperative mortality. Because these complications decrease survival, it is essential to assess the risk of occurrence of these events to inform patients.
晚期卵巢癌的治疗应包括最大限度减瘤手术，这是首要的预后因素。这种手术通常需要广泛切除（盆腔手术、广泛淋巴结清扫术、上腹部手术，有时还需要多次肠切除）。完整的手术通常在10%至100%的病例中需要切除膈肌腹膜，在20%至100%的病例中需要肠切除，在1%至33%的病例中需要脾切除，在0至11%的病例中需要胰腺切除，在0至16%的病例中需要切除肝转移灶，在2%至20%的病例中需要胆囊切除。报告的主要并发症包括消化瘘（1.4%至8.2%）、淋巴囊肿（0.6%至32%）、感染性并发症（3.7%至41.4%）以及膈肌手术时的肺部并发症（0至59%）。术后死亡率在0.3%至5.7%之间。根治性手术可提高完全减瘤率，但会带来显著的发病率和术后死亡率。由于这些并发症会降低生存率，因此评估这些事件发生的风险以告知患者至关重要。
