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目的探讨上皮性卵巢癌肝转移的治疗方法及影响其预后的因素。方法回顾性分析1992年3月至2005年4月我院治疗的32例上皮性卵巢癌肝转移患者的临床资料,包括患者年龄、病理类型、肝转移瘤情况、有无其它他部位转移、治疗方案及生存期等。根据随访结果计算生存率,并进行单因素和多因素分析。结果32例上皮性卵巢癌肝转移患者总的中位生存时间为11个月,1、3和5年累积生存率分别为53.6%、30.2%和9.0%。其中浆液性上皮性卵巢癌19例,中位生存时间为38个月,而非浆液性上皮性卵巢癌13例,中位生存时间仅为8个月(P<0.05);单纯肝转移患者中位生存时间为37个月,而肝脏转移合并其他部位转移(腹腔、肺部、淋巴结、骨等)患者中位生存时间仅为10个月(P<0.01)。单因素分析显示原发灶病理类型、治疗方案、肝内转移灶数目和部位、有无合并它处转移、肝转移后的全身化疗与预后相关。多因素分析显示病理类型、合并它处转移是影响其预后的独立危险因素。结论浆液性上皮性卵巢癌患者单纯肝转移后通过积极治疗,可明显改善预后。
Objective To investigate the treatment of epithelial ovarian cancer and its prognostic factors. Methods The clinical data of 32 patients with epithelial ovarian cancer with liver metastasis from March 1992 to April 2005 were analyzed retrospectively, including the age of patient, pathological type, metastasis of liver, the presence or absence of other sites metastasis, treatment Program and survival and so on. Survival rates were calculated based on follow-up results, and univariate and multivariate analyzes were performed. Results The median survival time of 32 patients with epithelial ovarian cancer with liver metastasis was 11 months. The cumulative survival rates at 1, 3, and 5 years were 53.6%, 30.2% and 9.0%, respectively. 19 cases of serous epithelial ovarian cancer, the median survival time was 38 months, while 13 cases of non-serous epithelial ovarian cancer, the median survival time was only 8 months (P <0.05); simple liver metastasis The median survival time was 37 months, while the median survival time in patients with liver metastases combined with other sites of metastasis (abdominal cavity, lung, lymph node, bone, etc.) was only 10 months (P <0.01). Univariate analysis showed that the primary tumor pathological type, treatment options, the number and location of intrahepatic metastases, with or without metastasis, systemic chemotherapy after liver metastases and prognosis. Multivariate analysis showed that pathological types, combined with metastasis elsewhere is an independent risk factor affecting its prognosis. Conclusion Positive treatment of serous epithelial ovarian cancer patients after liver metastasis can significantly improve the prognosis.