| The mortality rate of ovarian cancer ranks first in gynecologic malignant cancer. At present , the generally accepted treatment is thorough surgery and operative chemotherapy . By ovarian cancer cytoreductive surgery, the tumor in pelvic and abdominal cavity is resected furthest, creating the condition for chemotherapy to improve the survival rate and life quality of the patients. But, most of the patients with advanced ovarian cancer have been in advanced stage when they went to hospital. A considerable number of patients couldn't achieve satisfactory tumor cytoreductive surgery due to so many factors (eg: tumor offends important organs, tumor is fixed at the bottom of pelvic cavity or the condition of the patient is too bad to endure surgery), and have great trauma and slow recovery. Ovarian cancer is sensitive to a medium degree to chemotherapy, the response rate to platinum-based combination chemotherapy is 70%-80%. Neoadjuvant chemotherapy gives the patients limited course,improves the general condition, reduces and brises the tumor, creats the condition for surgery and improves the operation exhaustiveness.Purpose: 1.The aim of this study was to compare the women with advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy with those treated with conventionally surgery, to retrospectively study, to analyze the effect of different methods, to discuss the impact of neoadjuvant chemotherapy on the operation quality and prognosis of advanced ovarian cancer patients. 2. It was to compare the effect of PT regime with PAC regime in neoadjuvant chemotherapy group, which were seen as the first-line regime to treat advanced epithelial ovarian cancer.Methods: 1.To retrospectively analyze and compare 22 patients with advanced epithelial ovarian cancer, who gained the histological and pathologic diagnosis by 1) biopsies under ultrasound guidance; 2) biopsies from laparoscope checking; 3) ascites checking of cancer cell, and were treated with platinum-based combination chemotherapy, i.e. neoadjuvant chemotherapy followed by cytoreductive surgery, with 23 patients in stage III-IV of advanced epithelial ovarian cancer conventionally treated with cytoreductive surgery followed by platinum-based combination chemotherapy. 2. To compare the 13 patients treated with PT regime with the 9 patients with PAC regimeof the 22 patients in neoadjuvant chemotherapy group. 3. To conduct immunohistochemical examination (PCNA, Ki-67, bcl-2) on the advanced ovarian cancer (8 patients) after the treatment of neoadjuvant chemotherapy.Result: 1. neoadjuvant chemotherapy is the most operative treatment for the patients with advanced ovarian cancer who had extensive pelvic and abdominal metastasis and were assessed that they could not to achieve ideal cytoreductive surgery or their operation would cause great trauma. The patients with advanced ovarian cancer treated with neoadjuvant chemotherapy followed by cytoreductive surgery were compared with those treated with cytoreductive surgery followed by chemotherapy: the resection of primary and metastatic tumor was improved; the blood loss during the operation was reduced: the operative time, the number of postoperative days in the surgical intensive care unit and the number of postoperative hospitalization days were decreased (P<0.05). The progression-free and overall survival days were long, statistical difference was observed in survival curves (P<0.0001). 2. Statistical difference was observed in median tumor volume when the patients with PT (platinum+docetaxel) regime were compared with those with PAC (platinum+adriamycin+cyclophosphamide) regime, the patientswho underwent PT regime had smaller median tumor volume (P<0.05), which helped to achieve ideal cytoreductive surgery; no difference was observed in survival rate in two regimes treating advanced epithelial ovarian cancer. 3. Strong positive reaction of PCNA, Ki-67, bcl-2 before chemotherapy is depressed to weak negative or negative reaction.Conclusion: 1. neoadjuvant chemotherapy provides the patients with... |
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