Ayhan A, Tuncer Z S, Bükülmez O
Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
J Surg Oncol. 1995 Dec;60(4):268-76. doi: 10.1002/jso.2930600411.
One hundred sixty-eight patients treated at Hacettepe Hospital between 1969-1993 with metastatic ovarian tumors constituted 21.5% of all malignant ovarian neoplasms. Primary tumors were endometrial (51), breast (27), colorectal (18), and stomach cancer (17), lymphoma (14), sarcoma of the uterus (13), undetermined (11), tumors of the appendix (6) and ileum (4), carcinoma of the cervix (4), and gestational trophoblastic neoplasia (3). Overall 5-year and median survivals were 20.0% and 26.8% months, respectively. While worse prognoses were seen in gastric cancer and undetermined tumors followed by colorectal cancer, best survival figures were observed in endometrial cancer patients. A trend toward a better survival was seen with the advancement of the operation from bilateral salpingooophorectomy, and/or biopsy to total abdominal hysterectomy, bilateral salpingooophorectomy, total omentectomy, pelvic and paraaortic lymphadenectomy with debulking. Multivariate analysis identified the primary site, grade, laterality of involvement, type of surgery and adjuvant therapy status as significant prognostic parameters. Maximal surgical effort followed by adjuvant therapy might at least have some short term survival benefit in certain types metastatic to the ovaries.
1969年至1993年间,在哈杰泰佩医院接受治疗的168例转移性卵巢肿瘤患者占所有恶性卵巢肿瘤的21.5%。原发肿瘤为子宫内膜癌(51例)、乳腺癌(27例)、结直肠癌(18例)、胃癌(17例)、淋巴瘤(14例)、子宫肉瘤(13例)、未明确肿瘤(11例)、阑尾肿瘤(6例)和回肠肿瘤(4例)、宫颈癌(4例)以及妊娠滋养细胞肿瘤(3例)。总体5年生存率和中位生存期分别为20.0%和26.8个月。胃癌和未明确肿瘤患者的预后较差,其次是结直肠癌患者,而子宫内膜癌患者的生存率最高。随着手术方式从双侧输卵管卵巢切除术和/或活检进展到全腹子宫切除术、双侧输卵管卵巢切除术、全网膜切除术、盆腔和腹主动脉旁淋巴结清扫术并进行肿瘤细胞减灭术,生存率有提高的趋势。多因素分析确定原发部位、分级、受累侧别、手术类型和辅助治疗状态为重要的预后参数。对于某些转移至卵巢的肿瘤类型,最大程度的手术治疗后再进行辅助治疗可能至少有一些短期生存益处。