论文部分内容阅读
目的：探讨上皮性卵巢癌首次于本未能满意灭城及首次手术后复发的患者是否有价值进行第二次肿瘤细胞灭减术。方法：对33个患者施行了二次灭减术。其中首次手术未满意灭减，残留超过2cm，术后作1-2次化疗，再作二次灭减9例。首次手术后经6～8决计划性含铂类药物的联合化疗，临床至少缓解3个月，确诊复发施行二次灭减15例。二次探查术中发现复发施行二次灭减9例。结果：二次灭减达到肉眼无残留（A组）15例;残留＜2cm（B组）5例及残留超过2cm（C组）13例。A、B、C组的生存期中位数及2年生存率分别为59.9个月、20.6个月、8.29个月及93.3％、20％与7.69％（A对CP＜0.001、A对B及B对CP＜0.05）。结论：提示对手术后复发的患者二次灭减术是有价值的，但关键是二次灭减必须达到肉眼无残留，至少残留应＜2cm，为此建议可在二次灭减术前先作多途径、足够疗程的化疗，使肿瘤缩小及局限，力求满意切除肿瘤提高二次灭城的效果。
OBJECTIVE: To investigate whether epithelial ovarian cancer is the first time that this second tumor cell depletion therapy is worthwhile in patients who are not satisfied with extinction and after the first operation. METHODS: Thirty-three patients underwent a second ablation procedure. Among them, the first operation was not satisfied with the reduction, residual more than 2cm, 1-2 times after surgery for chemotherapy, and then for the second off in 9 cases. After the first operation by 6 to 8 scheduled platinum-containing drugs in combination with chemotherapy, clinical relief at least 3 months, the diagnosis of recurrence of the implementation of the second off in 15 cases. Secondary exploration found recurrence of the implementation of the second reduction in 9 cases. Results: There were 15 cases with no residual naked eye (group A) after secondary reduction; 5 cases with residual <2 cm (group B) and 13 cases with residual more than 2 cm (group C). The median survival time and 2-year survival rates in groups A, B and C were 59.9 months, 20.6 months, 8.29 months and 93.3%, 20% and 7.69%, respectively CP <0.05). CONCLUSIONS: It is valuable to suggest that secondary ablation should be performed in patients with recurrent postoperative recurrence. However, the key point is that the secondary ablation must achieve a naked eye residue of at least 2 cm. To this end, As a multi-channel, adequate course of chemotherapy, so that the tumor narrow and limitations, and strive to remove the tumor to improve the effect of the second out of town.