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目的 探讨复发性卵巢上皮癌二次细胞减灭术 (SCR)的作用及其影响因素。方法6 0例晚期卵巢上皮癌因肿瘤复发行SCR治疗。采用Cox逐步回归分析预后的影响因素 ;采用Logistic回归分析影响SCR的危险因素。结果 SCR术后残癌≤ 1cm组与 >1cm组的中位生存期分别为 19个月和 8个月 ,差异有显著性 (P =0 .0 0 0 0 )。缓解期 >12个月与≤ 12个月者 ,再手术后中位生存期分别为 12个月和 8个月 ,差异有显著性 (P =0 .0 2 2 4 )。肿瘤复发伴有腹水是预后的影响因素 ,同时也是影响SCR的主要危险因素。复发伴腹水者 ,SCR切净的可能减少了 2 0 .36倍。第 1次手术后残癌 >1cm是影响SCR的危险因素 (RR =5 .16 )。本组手术死亡率 1.7% ,术后并发症发生率 8.3%。结论 在有效二线化疗的配合下 ,SCR对首次行满意细胞减灭术、缓解期达 12个月以上、无腹水的复发性卵巢上皮癌患者有肯定的临床疗效
Objective To investigate the effect of secondary cytoreductive surgery (SCR) and its influencing factors on recurrent epithelial ovarian cancer. Methods Sixty patients with advanced epithelial ovarian cancer were treated with SCR. Cox stepwise regression analysis of prognostic factors; Logistic regression analysis of SCR risk factors. Results The median survival time of patients with SCR ≤ 1 cm and ≥ 1 cm after SCR was 19 months and 8 months, respectively, with significant difference (P = 0.000 0 0). The median survival time after reoperation was 12 months and 8 months, respectively. The difference was significant (P = 0.0224). Tumor recurrence associated with ascites is a prognostic factor, but also affect the SCR of the main risk factors. Recurrent patients with ascites, SCR cut net may be reduced 20.36 times. The first postoperative residual cancer> 1cm was a risk factor for SCR (RR = 5.16). The surgical mortality rate of 1.7%, postoperative complication rate of 8.3%. Conclusions In combination with effective second-line chemotherapy, SCR is the first time satisfactory cytoreductive surgery, mitigation for 12 months or more, ascites in patients with recurrent epithelial ovarian cancer have a positive clinical effect