Jong P, Sturgeon J, Jamieson C G
Department of Medical Oncology, Princess Margaret Hospital, Toronto, Ont.
Can J Surg. 1995 Oct;38(5):454-7.
To determine the benefit of palliative surgery for patients with advanced ovarian cancer and bowel obstruction and to identify criteria for selecting patients who are most likely to benefit from palliation.
A retrospective study of patients treated between 1982 and 1992.
A university-affiliated hospital.
Fifty-three patients with complete and unresolved bowel obstruction caused by ovarian cancer.
Surgery for relief of bowel obstruction.
Postoperative survival longer than 60 days, return home and relief of bowel obstruction for longer than 60 days, factors associated with failure of palliative surgery.
Successful palliation was achieved in 27 (51%) patients and was associated with the absence of four prognostic factors: palpable abdominal and pelvic masses, ascites exceeding 3 L, multiple obstructive sites and preoperative weight loss greater than 9 kg. Age, time interval between diagnosis of ovarian cancer and bowel obstruction, stage of disease at initial diagnosis, tumour type and grade, site and degree of obstruction, presence of gross residual tumour after initial operation and preoperative use of chemotherapy or radiotherapy did not indicate the success or failure of palliative surgery.
Palliative surgery for bowel obstruction in advanced ovarian cancer can be worthwhile, and there are four prognostic factors that indicate the likely failure of palliation.
确定姑息性手术对晚期卵巢癌合并肠梗阻患者的益处，并确定选择最可能从姑息治疗中获益患者的标准。
对1982年至1992年期间接受治疗的患者进行回顾性研究。
一家大学附属医院。
53例因卵巢癌导致完全性且未缓解肠梗阻的患者。
进行缓解肠梗阻的手术。
术后存活超过60天、回家且肠梗阻缓解超过60天、与姑息性手术失败相关的因素。
27例（51%）患者实现了成功的姑息治疗，且与不存在以下四个预后因素相关：可触及的腹部和盆腔肿块、腹水超过3升、多个梗阻部位以及术前体重减轻超过9千克。年龄、卵巢癌诊断与肠梗阻之间的时间间隔、初始诊断时的疾病分期、肿瘤类型和分级、梗阻部位和程度、初次手术后存在大体残留肿瘤以及术前使用化疗或放疗均不能表明姑息性手术的成功或失败。
晚期卵巢癌肠梗阻的姑息性手术可能是值得的，并且有四个预后因素表明姑息治疗可能失败。
