| The analysis of clinical and pathological prognostic factors for recurrent epithelial ovarian cancerObjective:To analyze the impact of clinical and pathological prognostic factors for recurrent epithelial ovarian cancer. Methods:Kaplan-meier survival curves, Log-rank test and Cox multivariate test regression were used to analysis clinical and pathological prognostic factors of relapse epithelial ovarian cancer in92cases with recurrent epithelial ovarian cancer which clinical pathology and follow-up data was completed. Results:1,92patients with recurrent epithelial ovarian carcinoma cases overall median survival time was18months (95%CI:16.065-19.948months).2, Kaplan-Meier univariate analysis showed that FIGO stage, recurrence time from last chemotherapy, recurrence site, the maximum recurrence lesion, relapse with ascites, CA125increased, secondary cytoreductive surgery, chemotherapy program for recurrence is the impact of important prognostic factor for re-treatment patients with recurrent EOC, P<0.1. But there was not relationship between age, grade of tumor cell, initial treatment plan and prognosis, P>0.1.3, The COX regression analysis showed that re-treatment regimen after relapse, the maximum recurrence of tumor size, recurrence site is an independent prognostic risk factor. Conclusion:There was multiple clinical and pathological factors for affecting prognosis of recurrence epithelial ovarian cancer, which re-treatment regimen after relapsed, the maximum recurrence lesion, recurrence site is an independent prognostic risk factor. The analysis of clinical and pathological factors of surgery effect for recurrent epithelial ovarian cancerObjective:To analyze the impact of clinical and pathological factors of surgery effect for recurrent epithelial ovarian cancer. Methods:Logistic regression,?2test, multivariate Logistic gradually regression were used to analysis clinical and pathological factors of surgery effect in60cases with recurrent epithelial ovarian cancer treatment by cytoreductive surgery. Results:1, The median survival time in60patients with recurrent epithelial ovarian cancer cases overall was26months (95%CI:18.302-33.698months). The median survival time in patients treated by optimal cytoreductive surgery was28months(95%CI:25.043-30.957months), that by suboptimal cytoreductive surgery cases was16months(95%CI:13.184-18.816months)(P=0.002).2, Logistic regression univariate analysis showed that recurrence number, relapse with ascites, recurrence site is the impact factors of surgery effect for recurrent EOC, P<0.05. But there was not relationship between age, initial surgery, Pathological type, grade of tumor cell, F1GO stage, initial chemotherapy program, recurrence time from last chemotherapy, recurrence CA125level, the largest recurrence lesion, prior chemotherapy. P>0.05.3, Logistic gradually regression analysis showed that recurrence number, recurrence site, relapse with ascites, age are significant factors of surgery effect for recurrent epithelial ovarian cancer. Conclusion:There was multiple clinical and pathological factors for affecting surgery effect for recurrent epithelial ovarian cancer., which recurrence number, recurrence site, relapse with ascites.age is an independent risk factor. System Analysis Of Cytoreductive Surgery For The Treatment Of Recurrent Epithelial Ovarian CarcinomaObjective:To systematically assess the role of cytoreductive surgery for the treatment of recurrent epithelial ovarian carcinoma and analysis of factors affecting survival. METHODS:The literature published between January1,1985and November30,2011were searched in PubMed,Embase,Medline, Cochrane Library, EBMR,CBM, CJFD, and CNKI to identify the retrospective?prospective?non randomized case-control studies. The literature was screened according to the inclusive and exclusive criteria by two reviewers independently,then the SPSS software was used for linear regression. RESULTS:40retrospective?7prospective and1non randomized case-control studies with2605patients were included. Simple linear regression showed that Statistical significance between optimal cytoreductive surgery rate and median overall survival(F=7.346, P=0.009)?between serous rate and median overall survival (F=5.537, P=0.025), between residual tumours and median overall survival (F=4.249, P=0.045),multiple linear regression showed that only Statistical significance between optimal cytoreductive surgery rate and median overall survival (P=0.009). CONCLUSION:cytoreductive surgery is suitable for platinum-sensitive and isolated nodules recurrent epithelial ovarian carcinoma.It can improve PFS and OS in recurrent EOC. To acquire the clear effect of SCRS in recurrent EOC, large sample randomized controlled study are required. The analysis of clinical and pathological prognostic factors for recurrent epithelial ovarian cancer of chemotherapyObjective:To analyze the impact of clinical and pathological prognostic factors for recurrent epithelial ovarian cancer of platinum-sensitive and platinum-resistance. Methods:Kaplan-meier survival curves, Log-rank test and Cox multivariate test regression were used to analysis clinical and pathological prognostic factors of relapse epithelial ovarian cancer in56platinum-sensitive and27platinum-resistance cases with recurrent epithelial ovarian cancer which clinical pathology and follow-up data was completed. Results:1,56platinum-sensitive recurrent epithelial ovarian carcinoma cases median progress-free survival was11months(95%CI:9.105-12.895) and overall median survival time was16months (95%CI:3.824-16.176),27platinum-resistance recurrent epithelial ovarian carcinoma cases median progress-free survival was8months (95%CI:4.219-11.781) and overall median survival time was10months (95%CI:3.824-16.176).2.Kaplan-Meier univariate analysis showed that the course of chemotherapy, relapse with ascites,chemotherapy program, the efficacy of chemotherapy for recurrence is the impact of important prognostic factor for platinum-sensitive patients with recurrent EOC,P<0.05, recurrence time from last chemotherapy, relapse with ascites, recurrence site the efficacy of chemotherapy for recurrence is the impact of important prognostic factor for platinum-resistance patients with recurrent EOC,P<0.05.3.The COX regression analysis showed that the course of chemotherapy,relapse with ascites, the efficacy of chemotherapy for platinum-sensitive recurrent epithelial ovarian carcinoma is an independent prognostic risk factor, recurrence site is the only independent prognostic risk factor for platinum-resistance recurrent epithelial ovarian carcinoma.Conclusion:To those who platinum-sensitive recurrent epithelial ovarian carcinoma,it is appropriate to choose the same platinum-base chemotherapy and encourage the patients to finish the6courses of chemotherapy. For recurrent lesions located in the peritoneal and plevic of platinum-resistance recurrent epithelial ovarian carcinoma should retreat active because it is the only independent prognostic risk factors. A large of cases to assess impact of prognostic risk factors in platinum-resistance recurrent epithelial ovarian. The effect of chemotherapy for recurrent epithelial ovarian cancer:A Meta AnalysisObjective:To systematically assess the different chemotherapy regimens of clinical efficacy and toxic reaction for recurrent epithelial ovarian cancer. Methods:The literature published between January1,1995and December31,2011were searched in PubMed,Embase.Medline, Cochrane Library, EBMR,CBM, CJFD, and CNKI to identify the RCT were searched about the effect of different chemotherapy regimens on progress free survival (PFS)?overall survival(OS)?the number of responses?complete responses?grade3-4hematologic toxicity reaction?grade3-4nonhematologic toxicity reaction for recurrent epithelial ovarian cancer. The literature was screened according to the inclusive and exclusive criteria by two reviewers independently,then the RevMan5.1software was used for meta-analyses. Results:14RCT (including7for platinum-sensitive and7for platinum-resistance) were included.Meta analysis showed that carboplatin-based chemotherapy was a favorable factor for OS (OR=0.50,95%CI:0.32-0.78, P=0.002) and responses rate (OR=1.87,95%CI:1.38-2.55, P<0.0001) in platinum-sensitive patients,but it was not a favorable factor for PFS (OR=1.19,95%CI:0.60-2.33, P=0.62)and can increase the risk of leukocyte reduction.Two studies show that topotecan can't improve OS and PFS in platinum-resistance patients. Gemcitabine was not a favorable factor for responses rate (OR=1.29,95%CI:0.67-2.46, P=0.45) and can increase the risk of neutropenia reduction (OR=2.97,95%CI:1.70-5.17, P=0.0001) compared with PLD in platinum-resistance patients. Conclusion:Carboplatin-based chemotherapy can improve OS and responses rate in platinum-sensitive patients.lt should pay attention to monitor hematologic toxicity reaction during chemotherapies. Topotecan can't improve OS and PFS in platinum-resistance patients.It is not a high methodological quality studies in this meta analysis and still more rigorous quality RCT study confirmed. |
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