Otsuka Isao, Matsuura Takuto
Dept. of Obstetrics and Gynecology, Kameda Medical Center.
Gan To Kagaku Ryoho. 2016 Dec;43(13):2547-2551.
To investigate residual disease status after primary cytoreductive surgery(PCS)in patients with advanced ovarian, Fallopian tube, or peritoneal carcinoma and long-term progression-free survival(PFS).
The study included patients with stage III C/IVepithelial ovarian, fallopian tube, or peritoneal carcinoma who had undergone surgery and carbo- platin/taxane chemotherapy, and had a PFSduration of ≥48 months.
The study group consisted of 11 patients with stage III C disease, which accounted for 23%(8/35)of stage III C patients aged ≤59 years and 11%(3/27)of stage III C patients aged ≥60 years. No stage IV patients had a long-term PFS(0/11). Of 8 patients aged ≤59 years, 2 had residual disease of 0.1-1 cm(optimal debulking), 5 had residual disease of >1 cm after PCS, and 1 who had received neoadjuvant chemotherapy(NAC)had optimal debulking during interval cytoreductive surgery. Of 3 patients aged ≥60 years, 2 had no macroscopic residual disease, and 1 had residual disease of >1 cm after PCS.
In patients with stage III C ovarian, fallopian tube, or peritoneal carcinoma, a subgroup of those aged ≤59 years had long-term PFSdespite suboptimal PCS. In this age group, carboplatin/taxane chemotherapy may improve the prognosis, irrespective of residual disease status after PCS. In contrast, complete cytoreduction during PCSappears to be necessary in patients aged ≥60 years who achieve long-term PFS.
探讨晚期卵巢癌、输卵管癌或腹膜癌患者接受初次肿瘤细胞减灭术（PCS）后的残留病灶状态及长期无进展生存期（PFS）。
本研究纳入了III C/IV期上皮性卵巢癌、输卵管癌或腹膜癌患者，这些患者均接受了手术及卡铂/紫杉烷化疗，且无进展生存期≥48个月。
研究组包括11例III C期疾病患者，占≤59岁III C期患者的23%（8/35），占≥60岁III C期患者的11%（3/27）。无IV期患者有长期无进展生存期（0/11）。在8例≤59岁的患者中，2例残留病灶为0.1 - 1 cm（最佳减瘤），5例PCS后残留病灶>1 cm，1例接受新辅助化疗（NAC）的患者在间隔期肿瘤细胞减灭术中实现了最佳减瘤。在3例≥60岁的患者中，2例无肉眼可见的残留病灶，1例PCS后残留病灶>1 cm。
在III C期卵巢癌、输卵管癌或腹膜癌患者中，≤59岁的亚组患者尽管PCS未达最佳状态仍有长期无进展生存期。在该年龄组中，无论PCS后的残留病灶状态如何，卡铂/紫杉烷化疗可能改善预后。相比之下，对于实现长期无进展生存期的≥60岁患者，PCS期间的完全肿瘤细胞减灭似乎是必要的。
