Scarabelli C, Campagnutta E, Zarrelli A, De Piero G, Sopracordevole F, Visentin M C, Giorda G, Sasso G M, Parin A, Gallo A
Divisione di Oncologia Ginecologica, Centro di Riferimento Oncologico, Aviano, PN.
Minerva Ginecol. 1994 Jan-Feb;46(1-2):5-13.
The aim of this study was to evaluate the value of second surgery in the combined and multidisciplinary treatment of mullerian ovarian cancer. A retrospective study was carried out in 86 consecutive patients with advances stages of mullerian ovarian cancer (stage 3-4) referred to the Division of Gynecological Surgical Oncology of the Oncological Reference Centre at Aviano for continuation of treatment following initial surgery and chemotherapy performed in various peripheral institutions. Second surgery only revealed 11.6% of complete endocelomatic pathological responses (10 patients) to earlier treatments; among the 76 patients with persistent disease it was possible to achieve optimal redebulking in 50 (65.8%) (31 R0 and 19 R1 after second surgery), whereas it was not possible to perform adequate second surgery in 26 (34.2%). The impact of second surgery on the probability of survival (mean survival rate) was highly significant in the 50 patients in whom it was possible to perform adequate second surgery compared to the non-operated group (14.34 months versus 6.10, chi square = 12.671, p = 0.0004). The authors underline both the prognostic value of lymph node status with increased mortality among patients with positive retro-peritoneal lymph nodes (LN+), and the value of retroperitoneal re-evaluation in predicting endo-peritoneal recidivation in patients with free abdomen who subsequently relapsed.
本研究的目的是评估二次手术在苗勒管卵巢癌综合多学科治疗中的价值。对86例连续的晚期苗勒管卵巢癌（3 - 4期）患者进行了一项回顾性研究，这些患者在阿维亚诺肿瘤参考中心的妇科肿瘤外科接受治疗，他们在不同的外周机构接受了初始手术和化疗后前来继续治疗。二次手术仅显示11.6%的患者（10例）对早期治疗有完全的腹腔内病理反应；在76例持续性疾病患者中，50例（65.8%）实现了最佳的再次减瘤（二次手术后31例R0和19例R1），而26例（34.2%）无法进行充分的二次手术。与未手术组相比，二次手术对50例能够进行充分二次手术患者的生存概率（平均生存率）影响非常显著（14.34个月对6.10个月，卡方 = 12.671，p = 0.0004）。作者强调了淋巴结状态的预后价值，腹膜后淋巴结阳性（LN +）患者的死亡率增加，以及腹膜后重新评估对预测腹腔无转移但随后复发患者的腹腔内复发的价值。
