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目的：对北京医科大学人民医院１９７０～１９９４年首次术中残留肿瘤组织最大径超过２ｃｍ的６９例卵巢上皮癌患者的治疗与预后进行回顾性分析。方法：６９例卵巢上皮癌中浆液性癌５４例、粘液性癌１０例、内膜样癌４例、透明细胞癌１例，其中Ⅱ期１例、Ⅲ期６４例、Ⅳ期４例。全部先行手术，确定组织类型、临床分期。２２例行第２次手术；７例行第３次手术。首次术后６７例进行了全身和腹腔化疗，２、３次术后对复发者又进行了全身化疗；对复发者中出现远处转移的９例患者除进行全身化疗，还进行了局部化疗，６例肺转移并出现胸水者加用了胸腔局部化疗，２例肝转移行肝动脉化疗，２例脑转移者行开颅术后全身化疗。结果：６９例中２年存活３２例（５０．７％）；５年存活１１例（２８．１％）；１０年存活３例，生存率１４．８％。６例肺转移合并胸水者，平均延长生存７个月（２～１２月）；２例肝转移者分别延长生存９及２９个月；２例脑转移者分别延长生存５、１６个月。结论：在卵巢癌首次术中应尽可能切除肿瘤组织，对残留肿瘤组织最大径超过２ｃｍ患者术后应积极化疗，对复发者应再次手术，化疗可延长患者生命。
OBJECTIVE: To retrospectively analyze the treatment and prognosis of 69 patients with ovarian epithelial carcinoma who had the largest diameter of residual tumor tissue more than 2 cm during the first operative period from 1970 to 1994 in People’s Hospital of Beijing Medical University. Methods: Seventy-nine cases of serous carcinoma, epithelial ovarian cancer, ovarian cancer, serous myeloma, myxoid carcinoma, myxoid carcinoma, myxoid carcinoma, myxoid carcinoma and so on were studied. Methods: 69 cases of ovarian epithelial carcinoma were serous carcinoma in 54 cases, mucinous carcinoma in 10 cases, endometrioid carcinoma in 4 cases, clear cell carcinoma in 1 case. All the first surgery to determine the type of tissue, clinical stage. 22 routine second surgery; 7 routine third surgery. The first postoperative 67 patients underwent systemic and intraperitoneal chemotherapy, 2,3 after surgery on recurrence and systemic chemotherapy; recurrence of distant metastasis in 9 patients in addition to systemic chemotherapy, but also for local chemotherapy, 6 cases of lung metastases and the presence of hydrothorax were treated with local thoracic chemotherapy, 2 cases of liver metastases were treated with hepatic artery chemotherapy, and 2 cases of brain metastases underwent craniotomy with systemic chemotherapy. Results: Of the 69 patients, 32 patients (50.7%) survived in 2 years, 11 patients (28.1%) survived in 5 patients, 3 patients survived in 10 years and the survival rate was 14.8%. Six patients with lung metastasis and pleural effusion prolonged their survival for an average of 7 months (range, 2 December). Two patients with liver metastases extended for 9 and 29 months, respectively. Two patients with brain metastases extended their survival by 5 and 16 months respectively. Conclusion: In the first operation of ovarian cancer, tumor tissue should be resected as much as possible. Patients with residual tumor with a diameter of more than 2 cm should be actively treated with chemotherapy and reoperation should be performed after recurrence. Chemotherapy can prolong patient’s life.