Venesmaa P
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
Obstet Gynecol. 1994 Jul;84(1):8-11.
To assess the impact of surgery and chemotherapy on survival in women with epithelial ovarian cancer.
Five hundred twenty-three women were treated at the same institution in 1977-1990. All pertinent data from patient files were collected by the author. Operations were performed by senior surgeons of the hospital. Cumulative survival and survival analysis with covariates (Cox model) were calculated. Multivariate analysis was used to assess the impact of surgery and chemotherapy on survival in 244 patients who had stage III epithelial ovarian cancer.
The overall cumulative 5-year survival for patients with epithelial ovarian cancer treated in the period 1977-1980 was significantly (P = .001) lower (33%) than that for patients treated in 1981-1985 (49%) or 1986-1990 (46%). The 5-year survival of women with stage III ovarian cancer improved from 10% in 1977-1980 to 27% in 1986-1990. In these stage III patients, chemotherapy containing cisplatin was associated with better survival than other chemotherapies, both in patients with optimal surgery (1.0- versus 2.9-fold risk of death) and in those with suboptimal surgery (1.4- versus 1.7-fold risk of death).
The results of this study suggest that cisplatin may be more important than surgery in improving survival in stage III epithelial ovarian cancer. Thus, epithelial ovarian cancer, at least in advanced stages, is a disease not curable with aggressive surgical procedures alone.
评估手术和化疗对上皮性卵巢癌女性患者生存率的影响。
1977年至1990年期间，523名女性在同一机构接受治疗。作者收集了患者病历中的所有相关数据。手术由医院的资深外科医生进行。计算累积生存率和带有协变量的生存分析（Cox模型）。多变量分析用于评估手术和化疗对244例III期上皮性卵巢癌患者生存率的影响。
1977年至1980年期间接受治疗的上皮性卵巢癌患者的总体累积5年生存率（33%）显著低于1981年至1985年（49%）或1986年至1990年（46%）接受治疗的患者（P = .001）。III期卵巢癌女性的5年生存率从1977年至1980年的10%提高到1986年至1990年的27%。在这些III期患者中，含顺铂的化疗与其他化疗相比，无论是手术效果最佳的患者（死亡风险为1.0倍与2.9倍）还是手术效果欠佳的患者（死亡风险为1.4倍与1.7倍），生存率都更高。
本研究结果表明，在提高III期上皮性卵巢癌患者生存率方面，顺铂可能比手术更重要。因此，上皮性卵巢癌，至少在晚期，不是仅通过积极的手术就能治愈的疾病。
