Yaegashi N, Sato S, Yajima A
Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
Gynecol Oncol. 1998 Mar;68(3):244-6. doi: 10.1006/gyno.1998.4946.
Our aim was to estimate the number of women in Japan in whom ovarian cancer could be prevented by performing prophylactic oophorectomy.
Of 1289 women who were diagnosed clinically and histologically as having primary cancers of the ovary between 1986 and 1995, 53 (4.1%) had undergone hysterectomy with conservation of one or both ovaries. Clinical data and representative microscopic slides for these 53 cases were evaluated.
Hysterectomy had been performed at the age 45 or above in 28 of the 53 patients (53%). We estimated that performance of prophylactic oophorectomy in women who underwent a hysterectomy at age 45 or older would prevent 2.2% (4.1% x 0.53) of the cases of ovarian cancer in Japan, which is below the 3.3% estimated for women in other countries. The interval between the hysterectomy and the diagnosis of ovarian cancer ranged from 1 to 29 years (mean 9.9 years). Fourteen patients (26%) developed ovarian cancer within 5 years of the hysterectomy. The overall 3-year survival rate of these 53 patients was 65%, not significantly different from that for patients with ovarian cancer in the national study in Japan.
Prophylactic oophorectomy for the prevention of ovarian cancer in Japanese women would appear to have a lesser impact than reported in other industrialized nations. The short interval between hysterectomy and the diagnosis of ovarian cancer observed in 26% of the patients suggested that ovarian cancer can develop within a few years of the visualization of apparently normal ovaries.
我们的目的是估计在日本通过进行预防性卵巢切除术可预防卵巢癌的女性人数。
在1986年至1995年间临床和组织学诊断为原发性卵巢癌的1289名女性中，53名（4.1%）接受了保留一侧或双侧卵巢的子宫切除术。对这53例病例的临床数据和代表性显微镜切片进行了评估。
53例患者中有28例（53%）在45岁及以上时进行了子宫切除术。我们估计，在45岁及以上接受子宫切除术的女性中进行预防性卵巢切除术可预防日本2.2%（4.1%×0.53）的卵巢癌病例，低于其他国家女性估计的3.3%。子宫切除术与卵巢癌诊断之间的间隔时间为1至29年（平均9.9年）。14名患者（26%）在子宫切除术后5年内患卵巢癌。这53例患者的总体3年生存率为65%，与日本全国性研究中卵巢癌患者的生存率无显著差异。
在日本，预防性卵巢切除术对预防卵巢癌的影响似乎比其他工业化国家报道的要小。26%的患者中观察到子宫切除术与卵巢癌诊断之间的间隔时间较短，这表明在卵巢外观正常的情况下，卵巢癌可能在几年内发生。
