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目的探索对于卵巢癌肠道转移患者较为理想的癌株减灭术式。方法选择2005年1月～2006年12月某科就诊的47例卵巢癌肠道转移患者,机械抽样随机把其中30例分为转移肠段切除组,余者分为肿瘤局部切除组。结果转移肠段切除患者5年生存期占40.0%,肿瘤局部切除患者5年生存期占11.8%,两组5年生存期构成比差异有统计学意义(P﹤0.05)。转移肠段切除组患者无进展生存期[(1.2±0.4)a]及总生存期[(3.9±1.1)a]比肿瘤局部切除组患者[(0.8±0.3)a]及[(3.3±1.7)a]显著长(P﹤0.05)。残余病灶﹤2cm的患者半年内复发率(21.2%)比残余病灶≥2cm患者的(57.1%)显著低(P﹤0.05),首次切除的患者半年内复发率(20.0%)比两次或以上切除患者的(52.9%)显著低(P﹤0.05)。对照显示,两组患者术后并发症发生率差异无统计学意义(P﹥0.05)。结论为提高卵巢癌肠道转移术后疗效及生存质量,癌株减灭术应尽量采取转移肠道切除术。同时如加强手术质量的控制,卵巢癌肠道转移的手术治疗也是较安全的。
Objective To explore the ideal method for cancer reduction in patients with intestinal metastasis of ovarian cancer. Methods Forty-seven patients with intestinal metastasis from January 2005 to December 2006 in our department were enrolled in this study. Thirty patients were randomly divided into two groups according to mechanical sampling and the others were divided into tumor resection group. Results The 5-year survival rate was 40.0% in patients with metastasis and 11.8% in patients with tumor resection. The difference of 5-year survival time was statistically significant (P <0.05). The progression-free survival [(1.2 ± 0.4) a] and overall survival (3.9 ± 1.1) a in patients who underwent resection of the bowel resection group were significantly higher than those in the tumor resection group (0.8 ± 0.3) and 3.3 ± 1.7 ) a] was significantly longer (P <0.05). Patients with residual lesions <2 cm had a significantly lower recurrence rate within 6 months (21.2%) than those with residual lesions> 2 cm (57.1%) (P <0.05). Patients with initial resections had a recurrence rate (20.0% Resection patients (52.9%) were significantly lower (P <0.05). The control showed no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusion In order to improve the curative effect and quality of life of patients with ovarian cancer after intestinal metaplasia, metastatic enteric resection should be used as far as possible to reduce the cancers. At the same time, such as strengthening the control of surgical quality, surgical treatment of intestinal metastasis of ovarian cancer is also more secure.