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卵巢癌是妇科三大肿瘤之一。因卵巢位于盆腔深部,卵巢癌患者多无明显症状,察觉时已是晚期。晚期卵巢癌恶性程度高,预后差,手术辅以化疗是目前主要治疗手段。手术中尽可能切除肿瘤、缩小残留病灶达到理想肿瘤细胞减灭术以延长生存期、改善预后。对于无法手术的晚期卵巢癌患者,新辅助化疗能够改善手术条件,增加手术满意度,是可行的治疗方案。因此,术前对晚期卵巢癌患者手术可行性进行评估,予以患者正确的首选治疗方案,提高手术满意度,避免不必要的剖腹探查。目前用以晚期卵巢癌肿瘤细胞减灭术术前评估的方法有1)影像学检查,如CT、PET,MRI等;2)CA125值,根据CA125值的高低评估手术可行性;3)腹腔镜探查,根据术中所见评估开腹手术可行性;4)其他各种肿瘤标记物如p53。各研究中探讨的手术评估手段大多局限于某一个方面,未能将有意义的预测因素全部纳入进行综合分析,准确性尚存在不足。探索新的方式方法,或是交叉应用两种或两种以上评估手段对晚期卵巢癌肿瘤细胞减灭术可行性进行综合评估,提高手术满意程度,缩小残留病灶,达到延长晚期卵巢癌患者生存时间和改善晚期预后的目的。本文就晚期卵巢癌肿瘤细胞减灭术可行性的评估和新辅助化疗的选择进行综述。
Ovarian cancer is one of three major gynecological tumors. Due to ovarian deep in the pelvis, ovarian cancer patients no obvious symptoms, is already late detection. Advanced ovarian cancer, a high degree of malignancy, the prognosis is poor, surgery with chemotherapy is the main treatment. Surgery to remove the tumor as possible, reduce residual lesions to achieve the desired tumor cytoreductive surgery to prolong survival and improve prognosis. For patients with advanced ovarian cancer who can not be operated on, neoadjuvant chemotherapy can improve the surgical conditions and increase the satisfaction of the operation, which is a feasible treatment plan. Therefore, preoperative evaluation of the feasibility of surgical treatment of advanced ovarian cancer patients to be the first choice of the right treatment options to improve surgical satisfaction, to avoid unnecessary laparotomy. Currently used for advanced ovarian cancer cytoreductive surgery preoperative assessment methods are 1) imaging studies, such as CT, PET, MRI, etc .; 2) CA125 value, according to the level of CA125 to assess the feasibility of surgery; 3) laparoscopic Exploration, according to intraoperative findings to assess the feasibility of laparotomy; 4) a variety of other tumor markers such as p53. Most of the surgical evaluation methods explored in each study are limited to one aspect, failing to include all the meaningful predictors in the comprehensive analysis, and the accuracy is still insufficient. Explore new ways and methods, or cross-application of two or more assessment methods for advanced ovarian cancer cytoreductive surgery feasibility of a comprehensive assessment to improve the degree of satisfaction with surgery to reduce the residual disease, to extend the survival of patients with advanced ovarian cancer And improve the prognosis of the late goal. This article reviews the feasibility of neoplastic cytoreductive surgery for advanced ovarian cancer and the selection of neoadjuvant chemotherapy.