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晚期卵巢癌手术后恢复预期的肿瘤治疗:一项叙述性综述

Return to intended oncological therapy following advanced ovarian cancer surgery: a narrative review.

作者信息

Tse Ka Yu, Chu Mandy Man Yee, Chiu Jessie Wan Kam, Kwok Shuk Tak, Irwin Michael G, Chan Aaron Hey Yin, Ho Polly, Cheng Calvin Pak Wing, Ngu Siew Fei, Chan Karen Kar Loen

机构信息

Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong SAR.

Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong SAR.

出版信息

Anaesthesia. 2025 Feb;80 Suppl 2(Suppl 2):106-114. doi: 10.1111/anae.16521. Epub 2025 Jan 8.

Abstract

INTRODUCTION

Patients with advanced ovarian cancer often require radical cytoreductive surgery and chemotherapy, with or without targeted therapy. Return to intended oncological therapy after surgery is a crucial metric, as delay can worsen survival. The concept of return to intended oncological therapy is important because it highlights the need for not just successful surgical outcomes, but also the ability to continue with the comprehensive cancer treatment plan.

METHODS

A comprehensive review of the literature was conducted to identify relevant English language studies published from January 2010 to September 2024.

RESULTS

Delayed return to intended oncological therapy after surgery was associated with poor survival outcomes in ovarian cancer. This narrative review investigates how pre-operative counselling and education; optimisation of the patient's medical condition; meticulous surgical planning and execution; early recognition of complications; and comprehensive postoperative care influence return to intended therapy in gynaecological surgery. Effective multidisciplinary care involving anaesthetists; nurses; physiotherapists; dietitians; psychologists; and the patient's relatives or friends, can prevent complications and ensure timely return to intended oncological therapy.

DISCUSSION

Awareness and management of factors affecting return to intended oncological therapy are essential for improving outcomes in patients with advanced ovarian cancer. We highlight the importance of multidisciplinary care (including enhanced recovery after surgery programmes) and the factors affecting these including age; nutrition; and occurrence of postoperative complications.

摘要

引言

晚期卵巢癌患者通常需要进行根治性细胞减灭术和化疗,可能还需要靶向治疗。术后恢复到预期的肿瘤治疗是一个关键指标,因为延迟会恶化生存情况。恢复到预期肿瘤治疗这一概念很重要,因为它不仅强调了成功手术结果的必要性,还强调了继续进行全面癌症治疗计划的能力。

方法

对文献进行全面综述,以确定2010年1月至2024年9月发表的相关英文研究。

结果

卵巢癌手术后延迟恢复到预期肿瘤治疗与不良生存结果相关。本叙述性综述探讨了术前咨询与教育、患者医疗状况的优化、精心的手术规划与实施、并发症的早期识别以及全面的术后护理如何影响妇科手术中恢复到预期治疗。涉及麻醉师、护士、物理治疗师、营养师、心理学家以及患者亲属或朋友的有效的多学科护理,可以预防并发症并确保及时恢复到预期肿瘤治疗。

讨论

认识和管理影响恢复到预期肿瘤治疗的因素对于改善晚期卵巢癌患者的预后至关重要。我们强调多学科护理(包括术后加速康复计划)的重要性以及影响这些的因素,包括年龄、营养和术后并发症的发生。

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