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[卵巢癌——解决方案近在咫尺?]

[Ovarian cancers--a solution within reach?].

作者信息

Haller U, Lütolf U M, Jungi W F

出版信息

Schweiz Med Wochenschr. 1983 Sep 10;113(36):1300-5.

PMID:6635629
Abstract

The overall 5-year survival rate for ovarian malignant tumors is approximately 25-30%. Ovarian cancer is usually recognized and diagnosed too late. Malignant ovarian tumors show a variety of biological and clinical features, as well as a wide spectrum of histiogenesis and histologic findings. The present study deals with epithelial ovarian tumors (80% of all malignant ovarian tumors): serous, mucinous, endometrioid and undifferentiated carcinoma. The incidence of malignant ovarian tumors varies between 2.5 in Japan and 15.1 in Sweden. The aim of surgical treatment lies in the radical removal of tumor masses without producing higher morbidity or mortality figures. Whenever possible the surgical treatment consists of median laparotomy, cytologic, anatomical and histologic staging, as radical as possible tumorectomy, hysterectomy with bilateral adnexectomy, omentectomy, and appendectomy. The prognosis of ovarian cancer depends on histologic findings, and also on the modalities of primary treatment. Further important prognostic factors are residual tumor masses after surgical treatment, the patient's age, the degree of differentiation and the extent of the tumor. Diagnosis, monitoring of patients and follow-up are directly influenced by dissemination of the tumor. Second-look laparotomy is the only reliable method of obtaining data in follow-up of the disease. Clinical assessment is important but insufficient in considering further treatment. Adjuvants to radical surgical treatment are chemotherapy and radiotherapy, for which the indications and therapy schedule are described.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

卵巢恶性肿瘤的总体5年生存率约为25% - 30%。卵巢癌通常确诊过晚。恶性卵巢肿瘤呈现出多种生物学和临床特征,以及广泛的组织发生和组织学表现。本研究涉及上皮性卵巢肿瘤(占所有恶性卵巢肿瘤的80%):浆液性、黏液性、子宫内膜样和未分化癌。恶性卵巢肿瘤的发病率在日本为2.5,在瑞典为15.1。手术治疗的目的在于彻底切除肿瘤肿块,同时不产生过高的发病率或死亡率。只要有可能,手术治疗包括正中剖腹术、细胞学、解剖学和组织学分期,尽可能进行根治性肿瘤切除术、子宫切除加双侧附件切除术、大网膜切除术和阑尾切除术。卵巢癌的预后取决于组织学表现,也取决于初始治疗方式。其他重要的预后因素包括手术治疗后残留的肿瘤肿块、患者年龄、分化程度和肿瘤范围。肿瘤的播散直接影响诊断、患者监测和随访。二次剖腹探查术是该病随访中获取数据的唯一可靠方法。临床评估很重要,但在考虑进一步治疗时并不充分。根治性手术治疗的辅助手段是化疗和放疗,文中描述了其适应证和治疗方案。(摘要截选于250词)

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