卵巢癌肠道转移64例临床分析.doc

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1、卵巢癌肠道转移64例临床分析作者：张师前智绪亭刘乃富刘香环【摘要】目的：回顾性分析卵巢癌肠道转移瘤的临床特点，评价手术切除的可行性及其与预后的关系。方法：64例肠道转移卵巢癌术前全面评估肠道受累程度。采用肿瘤细胞减灭术并行盆腔淋巴结清扫和腹主动脉旁淋巴结切除或/及活检术。肠道手术包括肿瘤剥除术或/及肠修补术、肠切除吻合术和结肠造口术。术后予以规律化疗，分析术后并发症及预后。结果：54例直肠/乙状结肠转移（84.4%），其他部位结肠转移26例，小肠转移18例；肠浆膜层及浅肌层浸润47例，深肌层及粘膜层浸润17例；上皮性癌侵及肠粘

2、膜者4例（7.7%），生殖细胞肿瘤无一例侵及肠粘膜；行肿瘤剥除44例，肠切除20例；直肠乙状结肠切除+吻合14例，6例行结肠造口。达到理想细胞减灭术56例（87.5%），其化疗后缓解率为58.9%，部分切除者8例化疗缓解率为12.5%；49例规则化疗者缓解率为65.3%，未完成充分化疗者为15.4%。术后并发症发生率26.6%，2例死于腹膜炎。结论：肠道是卵巢癌的常见转移部位，肠道的肿瘤剥除和肠切除术是达到理想肿瘤细胞减灭术的先决条件，术后规则化疗能改善卵巢癌患者预后。【关键词】卵巢肿瘤・肠・肿瘤转

3、移Intestinalmetastasisofovariancancer:clinicalanalysisof64cases【ABSTRACT】Objective:Toretrospectivelyanalyzetheclinicalfeaturesofintestinaltractmetastatictumorsofovariancancer,andestimatethefeasibilityofresectionanditsrelationtoprognosis.Methods:64patientswithovarianc

4、ancerassociatedwithintestinaltractmetastasiswerebroughtintothisclinicalanalysis.Theextentofintestinaltractinvolvementwasevaluatedpreoperatively.Cytoreductionwasdefinedastheresiduallesionlessthan1cm3,atthesametimepelvicandparaaorticlymphadenectomyand/orbiopsywereimpl

5、ied.Intestinalsurgeryincludedtumorstrippingsurgeryand/orintestinalrepair,intestinalresectionorcolostomy.Regularchemotherapywasadministrated,postoperativecomplicationsaswellasprognosiswereevaluated.Results:54cases(84.8%)hadrectum/sigmoidcolonmetastasis,metatsisinothe

6、rpartsofcolonwere26cases,smallintestinalmetastasiswere18cases,infiltrationofserosalandsuperficialmuscularlayerwere47cases,17caseshaddeepmuscularlayerandmucosalinfiltration.Epithelialcancerwhichhadinvadedintestinalmucosawere4cases(7.7%),noinvadingtointestinalmucosawa

7、sdetectedingermnoma.Allthe64patientswerereceptedsurgicaltreatment,includingtumorstrippingsurgeryin44cases,intestinalresectionin20cases,sigmoidalandrectalresectionin14cases,and5colonostomyin6cases.Theopticalcytoreductionwasachievedin56cases(87.5%),andpostchemotherpyr

8、egressionratewas58.9%,butthepostchemotherpyregressionratewasonly12.5%in8patientswhogotpartialresection;regularchemotherapywasfinishedin49c