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 determine the methods of treatment and the prognostic factors of hepatic metastasis in patients with epithelial ovarian cancer.

Methods

A retrospective review of 32 patients primarily treated in our hospital from 1992 to 2005 was conducted.Data were collected including age,the cell type of primary cancer, number of hepatic lesions, the presence of other sites of metastasis at the time of hepatic metastasis, the methods of treatment,chemotherapy,and survival periods.The factors effecting survival were studied by univariate and multivariate analysis.

Results

The overall median survival periods was 11 months. The 1-, 3-, and 5-years cumulative survival rates were 53.6%,30.2%and 9.0%respectively.Papillary serous histology was found in 19/32 patients with median survival time of 38 months, compared to 8 months with other cell type (P<0.05).The median survival from the time of diagnosis of liver metastasis for patients with only hepatic involvement was 37 months,compared to 10 months for those with metastasis in more than one site (P<0.01). Univariate analysis showed that the cell type of primary cancer, methods of treatment, the number of hepatic lesions, the presence of other sites of metastasis at the time of hepatic metastasis,chemotherapy were significant prognostic factors.The Cox multivariate proportional hazard model indicated that independent prognostic factors were cell type of primary cancer and the presence of other sites of metastasis at the time of hepatic metastasis.

Conclusion

The prognosis is significantly better for papillary serous histology tumor with hepatic involvement as the only site of disease.