Objective:To study the prognosis and factors affecting primary cytoreduction in advanced epithelial ovarian cancer.Methods: 111 cases of advanced epithelial ovarian cancer admitted in our hospital for primary cytoreduction from 2003 to 2007 were retrospectively analyzed by SPSS11.5 software.Results: In advanced ovarian cancer 3-year survival rates and 5-year survival rates were 37.8％ and 11.7％ respectively.Univariate analysis showed that patients with advanced, low grade, nonserosity, pleural fluid, metastasis in upper abdomen, less than 6 circles of chemotherapy and complications after operation had poor prognosis.Multivarivate analysis showed that residual tumor, histological differentiation and complication were independent predictors of survival.The prognosis of patients with metastasis in upper abdomen, low grade and nonserosity which degraded the rates of optimal cytoreduction was worse.Conclusions: In advanced epithelial ovarian cancer, the predictors of survival were as following: clinical stage, histological differentiation,pathological type, circles of chemotherapy, complication after operation, combined with pleural fluid, and metastasis in upper abdomen.Among them, residual tumor, histological differentiation and complication were the independent predictors of survival.Advanced ovarian cancer was prone to metastasize to upper abdomen.Patients with metastasis to upper abdomen were identified to have Iow probability of optimal debulking.So aggressive cytoreduction combined with platinum-based 6 circles of chemotherapy were necessary.%目的:探讨行初次肿瘤细胞减灭术的晚期卵巢上皮性癌的预后以及影响手术结果的因素.方法:应用SPSS 11.5统计学软件对2003～21307年我院收治的行初次肿瘤细胞减灭术的晚期卵巢上皮性癌111例的临床情况进行统计分析.结果:晚期卵巢上皮性癌的3年生存率为37.8%,5年生存率为11.7%.单因素分析表明,分期晚、分化差、非浆液性病理类型、合并胸水、合并上腹部转移、术后化疗少于6疗程、术后出现并发症者预后差.多因素分析表明残余病灶、组织学分化以及并发症是影响预后的独立因素.合并上腹部转移、低分化、非浆液性易降低满意的肿瘤细胞减灭术的比例从而影响预后.结论:临床期别、组织学分化、病理类型、术后化疗疗程、术后并发症、是否合并上腹部转移及胸水是影响晚期卵巢上皮性癌预后的因素,其中残余病灶、组织学分化以及并发症是影响预后的独立因素.晚期卵巢上皮性癌较易发生上腹部转移,合并上腹部转移影响手术满意减灭率.应积极的行肿瘤细胞减灭术.术后辅以铂类为基础的6疗程化疗.
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