| 摘要: |
| 目的 比较新辅助化疗（neoadjuvant chemotherapy, NACT）联合间歇性肿瘤细胞减灭术（interval debulking surgery, IDS）和初始肿瘤细胞减灭术（primary debulking surgery, PDS）在晚期卵巢癌患者中的疗效及安全性。方法 回顾性分析2016年1月至2018年12月海军军医大学长海医院收治的国际妇产科联盟（International Federation of Obstetrics and Gynecology, FIGO）分期ⅢC～Ⅳ期的上皮性卵巢癌患者124例，分为PDS联合化疗组（P组，n＝72）和NACT-IDS联合化疗组（NI组，n＝52）。比较两组患者一般资料、围手术期情况、术后并发症发生率、肿瘤完整切除率和无进展生存期（progression-free survival, PFS）。结果 NI组患者手术时间显著短于P组患者（P＜0.001），NI组患者术中出血量和输血量均显著少于P组患者（P＜0.05）。NI组R0切除的患者比例显著高于P组（84.60% vs 25.00%，P＜0.001）。NI组与P组患者中位住院时间分别为12 d和13 d，差异无统计学意义（P＝0.163）。NI组患者术后并发症（肠梗阻、感染、深静脉血栓）发生率显著低于P组（3.85% vs 11.11%，P＝0.037）。随访至2021年12月31日，NI组与P组患者的中位PFS分别为12.5个月和13个月，差异无统计学意义（P＞0.05）。结论 晚期卵巢癌患者使用NACT-IDS联合化疗较PDS联合化疗有更高的肿瘤完整切除率，手术时间更短、术中出血量更少，术后并发症发生率更低。 |
| 关键词: 卵巢癌 新辅助化疗 间歇性肿瘤细胞减灭术 初始肿瘤细胞减灭术 |
| DOI：10.12025/j.issn.1008-6358.2023.20221314 |
| 分类号: |
| 基金项目:国家自然科学基金(81702543),海军军医大学长海医院“234”攀峰项目(2019YXY014). |
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| Comparative study on the efficacy of neoadjuvant chemotherapy combined with interval debulking surgery and primary debulking surgery in the treatment of advanced ovarian cancer |
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LU Sheng-lian1, PENG Xiao-bo2, CAI Sheng-yun1
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1.Department of Obstetrics and Gynecology, Changhai Hospital, Naval Medical University, Shanghai 200433, China;2.Department of Oncology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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| Abstract: |
| Objective To compare the efficacy and safety of neoadjuvant chemotherapy (NACT) combined with interval debulking surgery (IDS) and primary debulking surgery (PDS) in the treatment of advanced ovarian cancer. Methods From January 2016 to December 2018, 124 patients with epithelial ovarian cancer classified by International Federation of Obstetrics and Gynecology (FIGO) stage ⅢC-Ⅳ in Changhai Hospital of Naval Medical University were retrospectively analyzed. They were divided into two groups: PDS combined chemotherapy group (group P, n=72) and NACT-IDS combined chemotherapy group (group NI, n=52). The general data, perioperative condition, incidence of postoperative complications, complete tumor resection rate and progression-free survival (PFS) were compared between the two groups. Results The operation time in group NI was significantly shorter than that in group P (P＜0.001). The intraoperative blood loss and blood transfusion volume in group NI were significantly less than those in group P (P＜0.05). The proportion of patients with R0 resection in group NI was significantly higher than that in group P (84.60% vs 25.00%, P＜0.001). The median hospitalization time of patients in group NI and group P was 12 days and 13 days respectively, and there was no significant difference between the two groups (P＞0.05). The incidence of postoperative complications (intestinal obstruction, infection, deep venous thrombosis) in group NI was significantly lower than that in group P (3.85% vs 11.11%). During the follow-up to December 31, 2021, the median PFS of group NI and group P was 12.5 months and 13 months respectively, there was no significant difference between the two groups. Conclusion NACT-IDS combined with chemotherapy has higher complete tumor resection rate, shorter operation time, less intraoperative blood loss and lower incidence of postoperative complications than PDS combined chemotherapy in patients with advanced ovarian cancer. |
| Key words: ovarian cancer neoadjuvant chemotherapy interval debulking surgery primary debulking surgery |
