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目的评价全盆腔器官切除术在晚期或复发妇科恶性肿瘤中的治疗价值并探讨影响预后的因素。方法回顾性分析1995年4月至2012年4月于浙江省肿瘤医院施行全盆腔器官切除术的16例晚期或复发妇科恶性肿瘤患者资料。结果中位随访时间37.5个月(3~157个月),5年总生存率51.6%。淋巴结状况显著影响患者的总生存期和无瘤生存期,其他可能影响预后的因素包括肿瘤直径、切缘状况等。最常见的并发症为盆腔积液伴感染(37.5%),最严重并发症为肠梗阻(25.0%)、尿瘘(18.8%)以及肠瘘(6.3%)。结论全盆腔器官切除术尽管并发症较多,但对于晚期或复发妇科恶性肿瘤患者来说仍是一种较安全且不明显影响生存质量的治疗方式,但术前必须严格筛选病例,排除无法切除或有远处转移的患者。
Objective To evaluate the value of total pelvic organ resection in the treatment of advanced or recurrent gynecological malignancies and to explore the factors influencing the prognosis. Methods The data of 16 patients with advanced or recurrent gynecologic malignancies who underwent total pelvic organ excision from April 1995 to April 2012 in Zhejiang Cancer Hospital were retrospectively analyzed. Results The median follow-up time was 37.5 months (range 3 to 157 months). The 5-year overall survival rate was 51.6%. Lymph node status significantly affects patient’s overall survival and disease-free survival. Other factors that may affect the prognosis include tumor diameter, margin condition and so on. The most common complication was pelvic fluid with infection (37.5%), the most serious complications were intestinal obstruction (25.0%), urinary fistula (18.8%) and intestinal fistula (6.3%). Conclusion Although total pelvic organ resection has more complications, it is still a safe and nonsignificant treatment for patients with advanced or recurrent gynecologic malignancies. However, patients must be screened strictly before operation to exclude unresectable Or distant metastasis of patients.