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目的 探讨综合治疗因素对中晚期上皮性卵巢癌预后的影响。方法 分析 1990～ 1997年治疗的 91例中晚期卵巢癌的手术范围、术后残余病灶大小、术后化疗疗程数及化疗途径 ,并随访预后。用Log -Rank检验和Cox模型作生存分析。结果 全组 3年和 5年存活率分别为 39 2 1%、2 6 89%。经单因素分析 ,与预后有关的因素是术后残余病灶大小、化疗疗程数、临床分期及组织学分级。经Cox模型多因素分析 ,影响预后的独立因子是临床分期和组织学分级。结论 手术范围和化疗途径与上皮性卵巢癌预后无关 ;手术达理想的肿瘤细胞减灭术及顺铂联合化疗≥ 6疗程者可获较长期生存 ;临床分期及组织学分级仍是影响卵巢上皮性癌预后的主要因素。
Objective To investigate the effect of comprehensive treatment on the prognosis of advanced epithelial ovarian cancer. Methods 91 cases of advanced ovarian cancer treated from 1990 to 1997 were analyzed in terms of operative range, postoperative residual tumor size, number of postoperative chemotherapy and chemotherapy, and prognosis of follow-up. Survival analysis was performed using Log-Rank test and Cox model. Results The 3-year and 5-year survival rates of the whole group were 39 2 1% and 26 89% respectively. After univariate analysis, the prognostic factors related to postoperative residual tumor size, number of chemotherapy courses, clinical stage and histological grade. Cox model by multivariate analysis, independent prognostic factor is the clinical stage and histological grade. Conclusions The surgical range and chemotherapy pathways have no relation with the prognosis of epithelial ovarian cancer. The optimal surgical cytoreductive surgery combined with cisplatin combined chemotherapy of 6 courses can achieve long-term survival. Clinical staging and histological grade still affect ovarian epitheliality Cancer prognosis of the main factors.