影响复发上皮卵巢癌手术疗效的临床病理因素分析

Clinicopathological Factors Influencing the Curative Effects of Surgery for Recurrent Epithelial Ovarian Cancer

  • 摘要:
      目的  分析影响复发卵巢上皮癌手术疗效的相关临床病理因素。
      方法  采用Logistic回归方法进行分析, 并通过多因素Logistic逐步回归分析对接受手术治疗60例复发卵巢上皮性癌患者进行影响手术疗效的临床病理因素相关分析。
      结果   1) 60例复发卵巢上皮癌术后平均中位生存时间为26个月(95%CI: 1 8.302~33.698), 其中肿瘤细胞减灭术满意者(残留灶≤2 cm)中位生存时间为28个月(95%CI: 25.043~30.957), 不满意者为16个月(95%CI: 13.184~18.816, P=0.002)。2)Logistic回归单因素分析显示复发数目、复发时伴有腹水、复发部位是影响手术满意效果的因素(P < 0.05);而年龄、初次手术情况、病理类型、细胞学分级、手术病理分期、初次化疗方案、复发距离末次化疗时间、复发CA125水平、最大复发病灶直径大小、术前先期化疗对手术效果无明显影响(P > 0.05)。3)Logistic逐步回归分析显示复发病灶个数、复发部位、复发后伴有腹水、年龄是影响手术满意度的主要因素。
      结论  多个临床病理因素影响复发卵巢上皮癌手术疗效, 其中复发病灶个数、复发部位、复发后伴有腹水、年龄是影响手术满意度的主要因素。

     

    Abstract:
      Objective   This study analyzed the effects of clinical and pathological factors on surgery for recurrent epithelial ovarian cancer (EOC).
      Methods  Univariate and multivariate step-wise logistic regression analyses were used to compare clinical and pathological factors that influenced the effects of cytoreductive surgery on 60 cases with recurrent EOC.
      Results  The overall median survival time of the 60 patients with recurrent EOC was 26 months (95% CI: 18.302 to 33.698 months). The median survival time in the patients treated by optimal cytoreductive surgery was 28 months (95% CI: 25.043 to 30.957months). By contrast, the median survival time in the patients treated by suboptimal cytoreductive surgery was 16 months (95% CI: 13.184 to 18.816 months) (P=0.002). Univariate logistic regression analysis showed that the recurrence number, relapse with ascites, and the recurrence site are factors of the surgical effects for recurrent EOC (P < 0.05). However, no relationships were observed among the following factors: age, initial surgery, pathological type, grade of tumor ceils, FIGO (International Federation of Obstetrics and Gynecology) stage, initial chemotherapeutic program, recurrence time since the last chemotherapy, recurrent CA125 level, largest recurrence lesion, and prior chemotherapy (P > 0.053). The logistic regression revealed that the recurrence number, recurrence site, relapse with aseites, and age are significant factors that gradually influence the effects of surgery for recurrent EOC.
      Conclusion  Multiple clinical and pathological factors will affect the results of surgery for recurrent EOC., The number and site of recurrence, as well as the age and relapse with ascites are independent risk factors.

     

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