The Relative Factors And Treatment Of Recurrent Epithelial Ovarian Cancer

The mortality of ovarian cancer is the highest among the femalegenital system cancer. One of the important reason is that the earlydisease is obscurity and lack of methods for diagnoses .When it isfound, the disease is almost advanced ,and there are about 50%patients will recurrent after systemic treatment in the near futureor at a specified future date. So how to delay the recurrence ofepithelial ovarian cancer has been the major point in the clinicwork. Now there are lots of materials to study the clinic charactersof epithelial ovarian cancer, in order to study the relative factorsof recurrence, prognostic and treatment of the recurrent epithelialovarian cancer, which can give help to the clinic work and increasethe survival rate of recurrent patients.Objective: This study was designed to explore the relative factorsfor the recurrence of epithelial ovarian cancer and its treatmentby analyzing retrospectively the 105 patients' clinic records,in order to give help to the treatment of recurrent epithelialovarian cancer.Methods:The clinic records of 105 patients with epithelial ovariancancer,admitted to our hospital from January 1993 to December 2002,were analyzed retrospectively. All patients were treated bysurgery, all cases' medical records and follow-up survey data werecompleteness, and the pathology slice were diagnosed by ourhospital, the follow-up survey were ended by January 2006. Factorsthat might be related to the recurrence of patients were analyzedusing χ2 test including age, FIGO stage, pathological type, sizeof residual tumor and the numbers of chemotherapy cycles after itsfirst operation. The survival time curves were described byKaplan-Meier using SPSS 13.0 statistical software, and the survivaldifference was tested by Log-rank test. P<0.05 was thought as hadstatistical difference.Results:1. 41 out of the 105 patients with epithelial ovarian cancerrecurred (39.0%), and the median recurrence-free time interval was13 months, the 3-years recurrent rates were 87.8%.2. ①The recurrent rates had no statistical difference between thepatients who were older than 55 years old or not, which recurrentrates were 32.1% and 41.6% respectively(p>0.05);②The recurrentrate of stage Ⅰ-Ⅱ (16.7%)was significant lower than that of stageⅢ-Ⅳ(45.7%) (P<0.05);③The recurrent rates had no statisticaldifference between the patients who had different pathological type(p>0.05);④There were statistical difference in recurrent rates,which recurrent rates of patients without or less than 2cm residuallesion and more than 2cm residual lesion were 32.4% and 60.6%respectively(P<0.05),among the patients of Ⅲ-Ⅳ who had thecytoreductive surgery;⑤The recurrent rates were 51.8%,25.8%,and22.2% respectively among the patients whose chemotherapy cycleswere less than six, six and more than six;The recurrent rates hadstatistical difference between the patients whose chemotherapycycles were more than six and less than six, and the recurrent ratesalso had statistical difference between the patients whosechemotherapy cycles were six and less than six(p<0.05);Therecurrent rates had no statistical difference between the patientswhose chemotherapy cycles were six and more than six(p>0.05).3. The whole median survival time for recurrent patients was 13months after its recurrence.①There were 22 patients who received recytoreductive surgeryfollowed chemotherapy ,and the median survival time afterrecurrence was 20 months, which was longer than the mediansurvival time of patients who received chemotherapy only. And thesurvival rate had statistical difference (P<0.05) tested byLog-rank test.②The patients who received recytoreductive surgery only, themedian survival time after recurrence was 8 and 11monthsrespectively, both of them were less than the whole median survivaltime.③There were 14 patients who received chemotherapy only, and themedian survival time of them was 12 months, among the patients therewere three cases received IL-2 during the treatment, and thesurvival time were 13,15 and 30 months;Two cases received TPchemotherapy, the median survival time after recurrence was 16 and24 months respectively.④ There were three patients who refused any treatment afterrecurrence, and the survival time were 13,15 and 30 monthsrespectively.4. There were 22 patients who received recytoreductive surgeryfollowed chemotherapy:①The median survival time of patients whoseDFI was less than 12 months was significant less than that ofpatients whose DFI was more than 12 months(P<0.01);②The mediansurvival time of patients without or less than 2cm residual lesionafter recytoreductive surgery was significant longer than who weremore than 2cm residual lesion (P<0.05);③The median survival timeof patients who had more than three times of chemotherapy afterrecytoreductive surgery was significant longer than who had lessthan three times of chemotherapy (P<0.01).Conclusions:1. FIGO stage, size of residual tumor and the numbers ofchemotherapy cycles after its first operation are the factorsrelated to the recurrence of epithelial ovarian cancer.2. It is important to keep close follow-up to the epithelial ovariancancer patients, especially in the first three years;Payattention to the physical check-up, the imageology examinationand the detection of tumor marks.3. The recytoreductive surgery followed salvage chemotherapy makebenefit to the selected recurrent patients.4. The recytoreductive surgery make benefit to the recurrentpatients whose DFI are longer, who are without or less than 2cmresidual lesion after recytoreductive surgery.5. We emphasize individual and synthesized therapy to the recurrentepithelial ovarian cancer patients in order to elevation thesurvival rate.