Chirurgia (Bucur). 2024 Sep;119(Ahead of print):1-11. doi: 10.21614/chirurgia.3023.
Ovarian surface epithelial cancer (OSEC) are an entity in which, according to genomics and pathology data accumulated in the last couple of decades, several different nosological entities with distinct etiologies are aggregated. In ovarian cancer, surgery is the pivot of treatment, to which medical oncological treatment is added by recommendation in most cases. Material and This is a single centre sample of 263 cases with OSEC operated from January 2014 until December 2021 with a 28-month period of follow-up, until 30th April 2024. OSEC surgical procedures in stages IIB to III and IV of the disease are complex interventions in order to have the R0/optimal cytoreduction achieved, so we summarised and coded them as follows: 1 = biopsy (of the tumour/peritoneum); 2 = bilateral/unilateral adnexectomy (BA/UA) total hysterectomy (TH) omentectomy +- peritoneal biopsies; 3 = (2) with total hysterectomy with bilateral adnexectomy (THBA) +- by extraperitoneal/subperitoneal route+peritonectomies (exclusively diaphragmatic) and electrocauterization of peritoneal carcinomatous lesions; 4 = (3) with visceral (multiple) resections +- stoma; 5 = (4) with diaphragmatic peritonectomies/stripping/partial resection of the diaphragm; 6 = palliative surgery. Debulking surgery (DS) was carried out for n = 182 patients with no residual tissue = R0 being registered in n = 41. Results for patients with residual tissue (n = 141) after DS recorded the following findings: 1 cm (49% cases), 1.1-2 cm (29%) and 2 cm (22%). Recorded results for endometrial ovarian carcinoma (EC) n = 27 shown a tumour free survival probability estimate (%) at 60 months of 66% as both surgery and platinum based chemotherapy are efficient. For clear cell ovarian carcinoma (CCC) n = 7 recorded results shown a tumour free estimate (%) at 60 months of 14%, being known the controversy as to whether or not paclitaxel is an active drug for CCC. Major complications were recorded in 25 patients with a fatality ratio of 5/25. Conclusion: Considering OSEC is a relatively rare disease and the importance of collecting substantial numbers of samples by histotypes to further knowledge about ovarian cancer it comes crucial to establish collaborative endeavour of tertiary centers with standardised and quality control strategies.
卵巢表面上皮性癌(OSEC)是一种实体瘤,根据过去几十年积累的基因组学和病理学数据,其中聚集了几种具有不同病因的不同疾病实体。在卵巢癌中,手术是治疗的核心,大多数情况下还需要进行医学肿瘤治疗。
这是一项来自单一中心的研究,纳入了 263 例于 2014 年 1 月至 2021 年 12 月接受 OSEC 手术的患者,随访时间为 28 个月,截止日期为 2024 年 4 月 30 日。对于疾病 IIB 至 III 期和 IV 期的 OSEC 手术是复杂的干预措施,目的是实现 R0/最佳肿瘤细胞减灭术,因此我们将其进行了总结和编码如下:1 = 肿瘤/腹膜活检;2 = 双侧/单侧附件切除术(BA/UA)全子宫切除术(TH)网膜切除术 +/-腹膜活检;3 = (2)全子宫切除术加双侧附件切除术(THBA) +/-经腹膜外/腹膜下途径+膈腹膜切除术(仅膈膜)和腹膜癌性病变电烙术;4 = (3)内脏(多处)切除术 +/-造口术;5 = (4)膈腹膜切除术/剥离/膈部分切除术;6 = 姑息性手术。182 例患者进行了肿瘤细胞减灭术(DS),无残留组织(n = 41)。对 DS 后有残留组织(n = 141)的患者进行了如下记录:1cm(49%的病例)、1.1-2cm(29%)和 2cm(22%)。记录 27 例子宫内膜卵巢癌(EC)患者的结果显示,60 个月时无复发生存率估计(%)为 66%,因为手术和基于铂类的化疗均有效。对于 7 例透明细胞卵巢癌(CCC)患者,记录的无复发生存率估计(%)为 60 个月时为 14%,目前存在紫杉醇是否对 CCC 有效的争议。25 例患者出现主要并发症,死亡率为 5/25。
考虑到 OSEC 是一种相对罕见的疾病,并且收集大量组织样本以进一步了解卵巢癌的重要性,因此建立具有标准化和质量控制策略的三级中心的协作努力至关重要。