Chishti Uzma, Aziz Aliya Begum
Kafkas University School of Medicine, Departments of Urology, Kars, Turkey.
Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2015 Mar;65(3):306-9.
To compare the peri-operative morbidity and survival rates between ovarian cancer patients treated with two different approaches.
The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data related to patients with advanced stage ovarian carcinoma treated between 1999 and 2008. Medical records were reviewed and relevant demographic, clinical, surgical, pathologic and follow-up information was acquired. Progression-free survival and overall survival rates were compared between patients who underwent primary debulking surgery and those who had received neo-adjuvant chemotherapy before surgery. SPSS 19 was used for statistical analysis.
Of the total 118 patients, 78(66%) had undergone primary debulking surgery and 40(34%) had received neo-adjuvant chemotherapy. The mean age and pre-operative carcinoma antigen-125 level were similar. The debulking group had 74(94.8%) patients with stage 3, and 4(5.1%) patients with stage 4 disease, while the other group had 32(80%) and 8(20%) with stage 3and 4 respectively. The frequency of optimal debulking was 42(56.8%) in the former group against 27(79.4%) in the latter (p=0.01). Duration of surgery, estimated blood loss >1500ml and stay at the intensive care unit were not statistically different (p>0.05). Rate of Urinary tract, bowel injury and bowel resections were also similar. There was no difference in the progression-free survival in both groups (p>0.05).
Neo-adjuvant chemotherapy followed by interval debulking produced comparable survival rates and peri-operative complications.
比较采用两种不同方法治疗的卵巢癌患者围手术期发病率和生存率。
这项回顾性研究在卡拉奇的阿迦汗大学医院开展，纳入了1999年至2008年期间治疗的晚期卵巢癌患者的数据。查阅病历并获取相关的人口统计学、临床、手术、病理和随访信息。比较接受初次肿瘤细胞减灭术的患者与术前接受新辅助化疗的患者的无进展生存率和总生存率。使用SPSS 19进行统计分析。
在总共118例患者中，78例（66%）接受了初次肿瘤细胞减灭术，40例（34%）接受了新辅助化疗。平均年龄和术前癌抗原125水平相似。肿瘤细胞减灭术组有74例（94.8%）患者为3期，4例（5.1%）患者为4期疾病，而另一组分别有32例（80%）和8例（20%）为3期和4期。前者组中最佳肿瘤细胞减灭术的频率为42例（56.8%），而后者为27例（79.4%）（p=0.01）。手术时间、估计失血量>1500ml和在重症监护病房的停留时间无统计学差异（p>0.05）。尿路、肠道损伤和肠道切除术的发生率也相似。两组的无进展生存率无差异（p>0.05）。
新辅助化疗后行间隔肿瘤细胞减灭术产生了相当的生存率和围手术期并发症。
