李少卿, 郗洪庆, 李佶阳, 张珂诚, 乔治, 卫勃, 陈凛. 83例胃癌卵巢转移临床病理特征及预后分析*[J]. 中国肿瘤临床, 2019, 46(14): 728-733. DOI: 10.3969/j.issn.1000-8179.2019.14.789
引用本文: 李少卿, 郗洪庆, 李佶阳, 张珂诚, 乔治, 卫勃, 陈凛. 83例胃癌卵巢转移临床病理特征及预后分析*[J]. 中国肿瘤临床, 2019, 46(14): 728-733. DOI: 10.3969/j.issn.1000-8179.2019.14.789
shu
Li Shaoqing, Xi Hongqing, Li Jiyang, Zhang Kecheng, Qiao Zhi, Wei Bo, Chen Lin. Clinicopathological characteristics and prognostic factors of 83 patients with ovarian metastasis from gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(14): 728-733. DOI: 10.3969/j.issn.1000-8179.2019.14.789
Citation: Li Shaoqing, Xi Hongqing, Li Jiyang, Zhang Kecheng, Qiao Zhi, Wei Bo, Chen Lin. Clinicopathological characteristics and prognostic factors of 83 patients with ovarian metastasis from gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(14): 728-733. DOI: 10.3969/j.issn.1000-8179.2019.14.789
shu

83例胃癌卵巢转移临床病理特征及预后分析*

Clinicopathological characteristics and prognostic factors of 83 patients with ovarian metastasis from gastric cancer

    摘要
  • 摘要:
      目的  探讨胃癌卵巢转移患者临床病理特征及影响预后的因素。
      方法  回顾性分析2006年1月至2017年12月83例于解放军总医院诊治胃癌卵巢转移患者的临床资料及治疗方法，对可能影响预后的因素行单因素或多因素分析。
      结果  83例患者中卵巢转移的中位直径为7.1(1.0~24.0) cm，转移病灶位于单侧36例(43.4%)，位于双侧47例(56.6%)，同时伴有腹膜转移35例(42.2%)。全组患者均行化疗，联合转移病灶切除57例(68.7%)，腹腔热灌注化疗22例(26.5%)。74例(89.1%)完成随访，中位生存期15(12.5~17.5)个月，1、3、5年生存率分别为71.1%、6.5%、0。单因素分析显示原发病灶淋巴结转移大于6个、转移病灶切除、同时性胃癌卵巢转移、合并腹膜转移、免疫组织化学法检测ER阳性、血清CEA及CA125升高是影响预后的因素(均P < 0.05)，多因素分析显示转移病灶切除、同时性胃癌卵巢转移、合并腹膜转移、免疫组织化学法检测ER阳性是影响预后的独立因素(均P < 0.05)。
      结论  同时性胃癌卵巢转移、合并腹膜转移患者预后较差，免疫组织化学法检测ER阳性患者预后好于阴性患者，转移病灶切除可延长患者的生存时间。

     

    Abstract:
      Objective  To explore the clinicopathological characteristics and prognostic factors of patients with ovarian metastasis from gastric cancer.
      Methods  We retrospectively analyzed the clinical data and treatment strategies of 83 patients with metastatic ovarian tumors treated at PLA General Hospital between January 2006 and December 2017. Univariate analysis using the Log-rank test and multivariate analysis using the Cox proportional-hazards model were used to identify the prognostic factors.
      Results  The median diameter of the metastatic ovarian tumors was 7.1 (1.0-24.0) cm. Of these patients, 36 (43.4%) had unilateral metastasis and 47 (56.6%) had bilateral metastasis; 35 (42.2%) patients had peritoneal metastasis. All patients received chemotherapy, including 57 (68.7%) patients who underwent combined-modality resection of the metastatic tumors and 22 patients (26.5%) who received hyperthermic intraperitoneal chemotherapy. Of these patients, 74 (89.1%) were followed up, with a median survival time of 1595% confidence interval (CI):12.5-17.5 months. The 1-year, 3-year, and 5-year overall survival rates were 71.1%, 6.5%, and 0, respectively. Univariate analysis showed that risk factors including ≥ 6 metastatic lymph nodes, metastasectomy, synchronous ovarian metastasis, peritoneal carcinomatosis, estrogen receptor (ER) positivity, and high levels of serum carcinoembryonic antigen and cancer antigen-125 (CA125) might affect the prognosis (P < 0.05). Multivariate analysis showed that metastasectomy, synchronous ovarian metastasis, combined peritoneal carcinomatosis, and ER positivity were independent factors affecting prognosis (P < 0.05).
      Conclusions  We found that the presence of synchronous ovarian metastasis or combined peritoneal carcinomatosis indicated a poor prognosis; in contrast, ER-positivity predicted a better prognosis than ER-negativity. Metastasectomy may prolong the survival of patients.

     

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