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原发性腹膜癌患者的临床特征:一家机构纳入8例患者的经验

Clinical characteristics of primary peritoneal carcinoma patients: a single-institution experience involving 8 patients.

作者信息

Hattori Satomi, Kajiyama Hiroaki, Fuji Utako, Furui Yuko, Ishibashi Yuki, Hattori Yuka, Takahashi Noriko, Kikkawa Fumitaka, Misawa Toshiya

机构信息

1Department of Obstetrics and Gynecology, Nagoya Ekisaikai Hospital, Nagoya, Japan.

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Nagoya J Med Sci. 2016 Dec;78(4):407-414. doi: 10.18999/nagjms.78.4.407.

Abstract

Primary peritoneal carcinoma (PPC) is treated similarly to advanced epithelial ovarian carcinoma (aEOC); however, the standard approach for the management of PPC is controversial. The objective of this study was to evaluate the clinical features and prognosis of those patients. A retrospective analysis was performed of eight patients with PPC between January 2008 and December 2015. Clinicopathologic parameters, the diagnostic modality, treatment, and oncologic outcome were analyzed. The median age at the time of diagnosis was 72.5 years (range: 55-79), with a median follow-up of 26.5 months (range, 5-74). Most of the PPC developed with carcinomatosis peritonei involving ascites, while some cases developed sporadically in the peritoneal or extraperitoneal cavity without ascites. The most common initial symptom was abdominal fullness, and other symptoms were inguinal tumor, paralysis of the extremities, and respiratory disorder. The preoperative CA125 value was elevated in all patients. In four patients who did not undergo primary surgery, the final diagnoses were determined by the ascites cytology and radiological image. Initial or interval debulking surgery was performed in only two patients. All patients were treated with paclitaxel or docetaxel plus carboplatin. Five showed a complete response (CR), and one showed a partial response (PR). Among the five patients with CR, the median progression-free and overall survival periods were 15 (12-26) and 41.5 (32-74) months, respectively. Three patients without carcinomatosis peritonei showed a relatively favorable prognosis. The management of PPC is generally consistent with that of aEOC; however, in atypical cases, the treatment method should be considered individually.

摘要

原发性腹膜癌(PPC)的治疗方法与晚期上皮性卵巢癌(aEOC)相似;然而,PPC的标准治疗方法存在争议。本研究的目的是评估这些患者的临床特征和预后。对2008年1月至2015年12月期间的8例PPC患者进行了回顾性分析。分析了临床病理参数、诊断方式、治疗方法和肿瘤学结局。诊断时的中位年龄为72.5岁(范围:55 - 79岁),中位随访时间为26.5个月(范围:5 - 74个月)。大多数PPC伴发腹膜癌病并伴有腹水,而有些病例在腹膜或腹膜外腔偶发且无腹水。最常见的初始症状是腹部胀满,其他症状包括腹股沟肿物、肢体麻痹和呼吸障碍。所有患者术前CA125值均升高。4例未接受初次手术的患者,最终诊断由腹水细胞学检查和影像学检查确定。仅2例患者进行了初始或间隔减瘤手术。所有患者均接受紫杉醇或多西他赛联合卡铂治疗。5例患者显示完全缓解(CR),1例患者显示部分缓解(PR)。在5例CR患者中,无进展生存期和总生存期的中位时间分别为15(12 - 26)个月和41.5(32 - 74)个月。3例无腹膜癌病的患者预后相对较好。PPC的治疗一般与aEOC一致;然而,在非典型病例中,应个体化考虑治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914d/5159466/cc91f3b0b3a3/2186-3326-78-0407-g001.jpg

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