卵巢癌肉瘤系列报道

作     者：Rutledge T.L Gold M.A McMeekin D.S 李奎 

作者机构：University of Oklahoma Health Sciences Center Oklahoma City OK 73104 United States 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2006年第2卷第5期

页      面：49-50页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：卵巢癌肉瘤 中位生存时间 进展时间 残留灶 肿瘤早期 肿瘤登记 异环磷酰胺 手术分期 辅助化疗 泰素 

摘      要：To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Methods. Thirty-one cases of ovarian carcinosarcoma were identified over a 6- year time period through tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P 0.05) were used to compare variables with outcome. Results. All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median followup was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly influenced progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease, presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide/cisplatin and 16 patients receiving carboplatin/taxol. Progression-free interval was improved with the use of ifosfamide/cisplatin vs. carboplatin/taxol. The median PFI was 12 months in the carbo/taxol group and has not been reached in the ifos/cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide/cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly influenced by type of adjuvant chemotherapy administered, P = 0.13. Conclusions. Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7- 10 months. Our series, although limited by a small number of patients, exhibits a more encouraging median survival of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide/cisplatin chemotherapy seem to be factors in this improved outcome.