Hoskins W J, Rubin S C, Dulaney E, Chapman D, Almadrones L, Saigo P, Markman M, Hakes T, Reichman B, Jones W B
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Gynecol Oncol. 1989 Sep;34(3):365-71. doi: 10.1016/0090-8258(89)90175-3.
The value of secondary cytoreductive surgery at the time of second-look laparotomy in patients with epithelial ovarian carcinoma is not established. Sixty-seven patients with residual carcinoma found at the time of second-look laparotomy performed at Memorial Sloan-Kettering Cancer Center between December 1, 1978, and May 30, 1986, were evaluated for survival relative to the success of secondary cytoreductive surgery. At second-look laparotomy, 17 patients had microscopic disease, 28 patients had disease less than 2 cm and 22 patients had disease greater than 2 cm. After secondary cytoreductive surgery 33 patients had microscopic disease, 26 patients had disease less than 2 cm, and 7 patients had disease greater than 2 cm (1 unknown). Five-year survival by Kaplan-Meier calculation was 62% for patients found to have microscopic disease at second-look laparotomy and 51% for patients whose disease was rendered microscopic by secondary cytoreductive surgery (P = 0.55). Patients left with gross disease (either less than or greater than 2 cm) had 5-year survivals of less than 10% (P = 0.013 compared with microscopic residual). Secondary cytoreductive surgery at the time of second-look laparotomy in patients with epithelial ovarian carcinoma may result in improved survival of patients who are reduced to microscopic residual disease.
上皮性卵巢癌患者在二次剖腹探查时进行二次细胞减灭术的价值尚未确定。对1978年12月1日至1986年5月30日期间在纪念斯隆凯特琳癌症中心进行二次剖腹探查时发现有残留癌的67例患者，就二次细胞减灭术的成功与否对其生存率进行了评估。在二次剖腹探查时，17例患者有微小病灶，28例患者病灶小于2厘米，22例患者病灶大于2厘米。二次细胞减灭术后，33例患者有微小病灶，26例患者病灶小于2厘米，7例患者病灶大于2厘米（1例情况不明）。通过Kaplan-Meier法计算，二次剖腹探查时发现有微小病灶的患者5年生存率为62%，经二次细胞减灭术使病灶变为微小的患者5年生存率为51%（P = 0.55）。术后仍有肉眼可见病灶（无论小于还是大于2厘米）的患者5年生存率低于10%（与微小残留相比，P = 0.013）。上皮性卵巢癌患者在二次剖腹探查时进行二次细胞减灭术，对于那些残留病灶减至微小的患者，可能会提高其生存率。
