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美国国立卫生研究院共识发展会议声明。卵巢癌:筛查、治疗及随访。

National Institutes of Health Consensus Development Conference Statement. Ovarian cancer: screening, treatment, and follow-up.

出版信息

Gynecol Oncol. 1994 Dec;55(3 Pt 2):S4-14. doi: 10.1006/gyno.1994.1333.

Abstract

The National Institutes of Health Consensus Development Conference on Ovarian Cancer-Screening, Treatment, and Follow-up brought together epidemiologists; obstetrician/gynecologists; gynecologic, medical, and radiation oncologists; and the public to address the following questions: (1) What is the current status of screening and prevention in ovarian cancer? (2) What is the appropriate management of early-stage ovarian cancer? (3) What is the appropriate management of advanced epithelial ovarian cancer? (4) What is the appropriate follow-up after primary therapy? and (5) What are the directions for future research? The consensus panel concluded that there is no evidence available as yet that the current screening modalities of CA 125 and transvaginal ultrasonography can be effectively used for widespread screening to reduce mortality from ovarian cancer nor that their use will result in decreased rather than increased morbidity and mortality. They recommended that further prospective research be done to evaluate this very important issue. Women with stage IA grade 1 and most IB grade 1 ovarian cancer do not require postoperative adjuvant therapy. Many remaining stage I patients do require chemotherapy. Subsets of stage I must be fully defined and ideal treatment must be determined. Women with stages II, III, and IV epithelial ovarian cancer (other than low malignant potential tumors) should receive postoperative chemotherapy. Physicians should be encouraged to discuss clinical trial participation with women, and women should be encouraged to participate. All women should have access to accurate and complete information regarding ovarian cancer. Furthermore, there must be no barriers to women's access to qualified specialists, optimal therapy, and protocols. The full text of the consensus panel's statement follows.

摘要

美国国立卫生研究院关于卵巢癌筛查、治疗及随访的共识发展会议汇聚了流行病学家、妇产科医生、妇科肿瘤学家、医学肿瘤学家、放射肿瘤学家以及公众,以探讨以下问题:(1)卵巢癌筛查与预防的现状如何?(2)早期卵巢癌的恰当管理措施是什么?(3)晚期上皮性卵巢癌的恰当管理措施是什么?(4)初始治疗后的恰当随访方案是什么?以及(5)未来研究的方向是什么?共识小组得出结论,目前尚无证据表明,现有的CA 125和经阴道超声筛查方式可有效用于广泛筛查以降低卵巢癌死亡率,也没有证据表明使用这些方式会降低而非增加发病率和死亡率。他们建议开展进一步的前瞻性研究以评估这一非常重要的问题。IA期1级和大多数IB期1级卵巢癌女性无需术后辅助治疗。许多其余的I期患者确实需要化疗。必须充分界定I期的亚组,并确定理想的治疗方法。II期、III期和IV期上皮性卵巢癌(低恶性潜能肿瘤除外)女性应接受术后化疗。应鼓励医生与女性讨论参与临床试验的事宜,也应鼓励女性参与。所有女性都应能获取有关卵巢癌的准确且完整的信息。此外,女性在获取合格专家的服务、最佳治疗及方案方面不应存在障碍。共识小组声明的全文如下。

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