Kebapcı Eyüp, Gülseren Varol, Tuğmen Cem, Gökçü Mehmet, Solmaz Ulaş, Sert İsmail, Kocaer Mustafa, Özer Mehmet, Ölmez Mustafa, Sancı Muzaffer
Ginekol Pol. 2017;88(10):537-542. doi: 10.5603/GP.a2017.0098.
The aim of this study is to evaluate the results of advanced stage (stage IIIB-IVB) ovarian cancer (OC) patients with intestinal metastasis, and to investigate the factors that affect survival.
Patients who underwent cytoreductive surgery (CS) for FIGO stage IIIB-IVB OC with metastasis in the intestinal system, at Tepecik Research and Treatment Hospital between 2008-2014, were analyzed retrospectively. Patients with borderline ovarian tumor; those who had previously undergone radiation therapy and/or hysterectomy and patients having secondary or tertiary cytoreduction were excluded and 49 patients were included and analyzed in this study. Hysterectomy, bilateral salpingo-oopherectomy, pelvic and para-aortic lymph node sampling, resection of bulky lymph nodes and omentectomy were performed. Optimal cytoreduction was accepted as that which left residual tumor ≤ one cm maximum size.
The risk factors affecting OS interval were investigated according to Cox' regression analysis. Optimality of the primary CS (P = 0.008 and HR = 5.202) and cancer stage (P = 0.016 and HR = 6.083) were found to be statistically significant factors.
Achieving optimal CS is the most important aim for the general surgeon carrying out an intestinal resection procedure. Although resection procedures are superior in providing the desired optimal results when compared to excision surgery, their higher complication rates and subsequent lower quality of life must be taken into consideration when choosing either resection or excision methods; surgical intervention should always be kept to the minimum possible.
本研究旨在评估晚期(IIIB-IVB期)伴有肠道转移的卵巢癌(OC)患者的治疗结果,并探讨影响生存的因素。
回顾性分析2008年至2014年在Tepecik研究与治疗医院因FIGO IIB-IVB期OC伴肠道系统转移而接受减瘤手术(CS)的患者。排除交界性卵巢肿瘤患者;既往接受过放疗和/或子宫切除术的患者以及接受二次或三次减瘤手术的患者,本研究纳入并分析了49例患者。实施了子宫切除术、双侧输卵管卵巢切除术、盆腔和腹主动脉旁淋巴结取样、切除肿大淋巴结和大网膜切除术。最佳减瘤定义为残留肿瘤最大尺寸≤1厘米。
根据Cox回归分析研究了影响总生存期(OS)的危险因素。发现初次CS的最佳程度(P = 0.008,HR = 5.202)和癌症分期(P = 0.016,HR = 6.083)是具有统计学意义的因素。
实现最佳CS是实施肠道切除手术的普通外科医生的最重要目标。尽管与切除手术相比,切除手术在提供理想的最佳结果方面更具优势,但在选择切除或切除方法时,必须考虑其较高的并发症发生率和随后较低的生活质量;手术干预应始终保持在尽可能低的水平。