Landoni F, Pellegrino A, Cormio G, Milani R, Maggioni A, Mangioni C
Department of Obstetrics and Gynecology, University of Milan, Istituto di Scienze Biomediche-Ospedale S. Gerardo-Monza, Italy.
Acta Obstet Gynecol Scand. 1998 Feb;77(2):233-7.
To evaluate the role of platin-based chemotherapy followed by salvage surgery in patients with recurrent ovarian cancer after negative second-look laparotomy.
A retrospective chart review was conducted on 38 patients with recurrent ovarian cancer after a pathologic complete response to first-line chemotherapy. After diagnosis of recurrence all patients underwent retreatment with platin-based chemotherapy followed by radical salvage surgery.
Recurrent disease was diagnosed at a median interval of 22 months after second-look surgery. All patients had complete surgical debulking with no macroscopic tumor at the completion of the surgical procedure. Eight patients (21%) required an intestinal resection but no colostomy was performed. Two operative deaths occurred (5%). Twenty-two patients (58%) experienced a second recurrence after salvage surgery The median survival time for all patients after diagnosis of recurrent disease was 29 months (range 6-96 months), with nine patients (25%) surviving more than three years. Survival time after diagnosis of recurrence was not significantly related either to known prognostic factors of ovarian cancer or to the length of the clinical remission time.
Retreatment with platin-based chemotherapy followed by salvage surgery should be offered to recurrent ovarian cancer patients and would appear to prolong survival in a highly selected group of patients.
评估铂类化疗后行挽救性手术在二次探查剖腹术后复发卵巢癌患者中的作用。
对38例一线化疗后病理完全缓解的复发性卵巢癌患者进行回顾性病历审查。复发诊断后，所有患者均接受铂类化疗再治疗，随后行根治性挽救性手术。
复发疾病在二次探查手术后的中位间隔时间为22个月被诊断出来。所有患者手术均完全切除肿瘤，手术结束时无肉眼可见肿瘤。8例患者（21%）需要行肠切除术，但未进行结肠造口术。发生2例手术死亡（5%）。22例患者（58%）在挽救性手术后出现二次复发。复发疾病诊断后所有患者的中位生存时间为29个月（范围6 - 96个月），9例患者（25%）存活超过三年。复发诊断后的生存时间与卵巢癌已知的预后因素或临床缓解时间的长短均无显著相关性。
复发性卵巢癌患者应接受铂类化疗再治疗后行挽救性手术，这似乎能延长高度选择的一组患者的生存期。
