OVARIAN CANCER

Ovarian cancer is the worst prognosis of gynecologic tumors. Patients with advanced epithelial ovarian cancer five-year survival rates generally below 30%, mainly in patients with relapsing most (about 75%), relapse after chemotherapy to poor results.

For the treatment of recurrent ovarian cancer chemotherapy drugs many, no less than 10 species, but only clinical remission rate of 20% to 30%, no progress median survival time (PFS) for 2 to 6 months, the median overall survival (OS) for six to 12 months. Therefore, to improve the efficacy of chemotherapy drugs delay, but the development of new drugs is very difficult, efficient use of existing drugs is an effective way to <BR>.

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Patients with malignant ovarian tumor when treatment is late (> Phase II), ovarian cancer is the surgical treatment called tumor or cytoreductive surgery or large resection.
Surgery is to do everything possible to the original tumor resection and can see the pots, peritoneal metastasis, so that each region of residual lesion diameter of less than 2.0 cm to 1.5 cm. Intraoperative from ascites fluid or cells for blood screening. Because ovarian and uterine cancer often, the annex or visco-invasion, peritoneal and keep pots, it is more of "carpet-volume" or "dumplings", from extraperitoneal space elements from the peritoneal wall, bladder and pelvic floor serous peritoneal, along with the uterus and pelvic peritoneum block tumor resection. The pots have peritoneal metastasis tissues or organs should be possible to complete resection or partial resection, resection of the omentum, some intestinal resection, resection of the bladder or ureter shifting values. The removal of the tumor as possible aim is to enhance postoperative radiotherapy and chemotherapy effect. The merger of ovarian cancer ascites, regardless of whether all resection are advised to intraperitoneal indwelling catheter for intraperitoneal injection of anti-cancer drugs. Anti-cancer drugs or radioisotopes for preparation also can be injected directly unresectable tumors.
Surgery can not decide in its benign and malignant ovarian tumor resection specimens should be admitted or contralateral ovarian tissue frozen tablets sent for histopathologic examination. There is no such conditions, generally after the contralateral normal ovarian As can be temporarily retained, pathological specimens were sent checks to clear in nature, and close observation. The previous suspected metastatic ovarian tumor and failed to find its source, should be in operation in detail in the original exploration of abdominal lesions, after further treatment for reference.

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Cytoreductive surgery in the treatment of ovarian cancer Comprehensive Application and prospects

Foreign Medical Obstetrics and Gynecology volumes in 1999 Vol 26 No. 2

Tianjin Medical University General Hospital of Obstetrics and Gynecology (300,052) of the new QU (Summary) if Mi (revision)

Abstract <BR> since the 1980s, complete cytoreductive surgery to cisplatin-based combination chemotherapy for ovarian cancer as a conventional model, cytoreductive surgery is the complete impact of the prognosis of patients with one of the important factors for recurrent ovarian cancer once again cytoreductive surgery still some value , but to improve the survival rate of patients is more important to be effective after chemotherapy treatment as a necessary complement. Early ovarian cancer retroperitoneal lymph node dissection is reasonable and significance of the still controversial.

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[Summary]

Ovarian cancer is a common cancer of female genital mutilation one of the incidence of cervical cancer and after cancer of the uterus, which ranked third. But ovarian cancer death, accounts of the first gynecologic tumors, right pose a serious threat to women's lives. Because ovarian embryonic development, organization anatomy and endocrine function more complicated, it may be suffering from benign tumors or malignant. Because of early ovarian cancer in asymptomatic, and the identification of its type benign and malignant very difficult, ovarian carcinoma laparotomy in ovarian tumor confined to only 30%, most have spread to the uterus, bilateral annex, the omentum and pelvic organs, both in the diagnosis of ovarian cancer and governance the treatment is a major problem indeed. Over the years experts on the pathological form of ovarian cancer, the development of clinical and treatment programs for many of accumulated a lot of experience, so far, statistics on domestic and foreign clinical data, the five-year survival rate of only 25% to 30%.

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Common and prognosis factors:

• clinical stage and is closely related to survival;

• histological type and grade pathology and prognosis is directly related;

• differentiation and biological characteristics and the prognosis also directly related to a direct impact on the survival rate and survival time.

• In addition, the age factor and the prognosis of more closely. Another treatment option with a reasonable and thorough, but also directly affect the prognosis of ovarian cancer.

Tags: age, body, cancer, chemotherapy, clinical, eat, exploration, life, method, ovarian, patients, prognosis, rate, residual, surgery, survival, therapy, time, treatment, tumor

The choice of ovarian cancer surgery, chemotherapy and radiotherapy. But because of its pathological type complex, qualitative, without a diagnosis and staging laparoscopy or laparotomy, it is difficult clear. In addition to surgery is not generally the case or have the type of tumor in patients with systemic conditions not competent to surgery, chemotherapy or radiotherapy to trial again after surgery to consider, as appropriate, generally the preferred treatment. Surgical exploration can be further defined tumor types and scope of involvement, clear staging, not only for postoperative chemotherapy and radiotherapy provide basis, and possible removal of the tumor, chemotherapy or postoperative radiotherapy or create conditions to improve efficacy.

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Ovarian cancer
	The prognosis and outcome Common and prognosis factors: • clinical stage and is closely related to survival; • histological type and grade pathology and prognosis is directly related; • differentiation and biological characteristics and the prognosis also directly related to a direct impact on the survival rate and survival time. • In addition, the age factor and the prognosis of more closely. Another treatment option with a reasonable and thorough, but also directly affect the prognosis of ovarian cancer. Both the borderline epithelial ovarian cancer or other types of ovarian cancer, the need for close follow-up after treatment, such as timely found evidence of recurrence, surgery or chemotherapy again. Patients may extend life, even cured. Tumor markers for the periodic inspection, review of RII, body check and some other auxiliary are to be brought to the attention of track. Major ovarian cancer recurrence after surgery three years ago, after two exploration average recurrence time in 24 months, two exploration negative does not mean relapse. Overall the prognosis of patients with tumor stage, the residual disease after surgery at the size, pathologic classification and treatment methods, and have relations.

Tags: age, body, cancer, cell, cells, chemotherapy, clinical, eat, exploration, life, method, ovarian, patients, prognosis, rate, residual, surgery, survival, therapy, time, treatment, tumor

Clinical manifestations

(1) a <BR> symptoms, age occurred in perimenopausal women. Over more than 35 years of epithelial ovarian cancer, while those below the age of 35 occurred reproductive cell malignancies.
2, the pain may be due to malignant ovarian tumor of the changes, such as hemorrhage, necrosis, the rapid growth caused a considerable degree of persistent pain. The inspection found a local tenderness.
3, Irregular Menstruation see irregular bleeding, bleeding after menopause.
4, weight loss was sexually advanced thin.

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Surgery

According to a medical examination and transvaginal ultrasound findings suspected ovarian cancer is often a laparotomy to be confirmed histology, and tumor stage and tumor debulking surgery. Histological need to be certified to remove ovarian cysts Mixed other causes, including non - epithelial ovarian cancer (such as interstitial or germ cell tumors), other primary site of tumor metastasis to the ovary (such as the adhesion of), or benign lesions, such as endometriosis. The adhesion is usually of signet ring cell tumor, representatives from primary adenocarcinoma of the stomach metastatic ovarian cancer. However, other parts of the original cancer, such as colon, appendix, the gallbladder and breast (special lobular invasive carcinoma) will also transfer to ovarian. At laparotomy surgery during the stage, right after the decision-making guidance provided important information, especially for patients with early (discussed below). Finally, the tumor debulking surgery (initial cytoreductive surgery) is the first of an important part of the operation because of residual tumor with a diameter of less than 1 cm larger than the residual tumor with a high survival rate.

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A benign ovarian tumors young patients affected Annex tumor resection or stripped of. If both bilateral ovarian tumors, should fight to retain part of normal ovarian tissue. Before post-clearance as abdominal specimens suspected malignant sent frozen biopsy. Patients before and after menopause to be hysterectomy and bilateral resection of the Annex to activities.

2, malignant ovarian tumor treatment to the main, supplemented by chemotherapy, and radiotherapy.

(1) to general surgery for hysterectomy, bilateral Annex and the omentum resection. Patients with advanced cancer should be possible for the transfer to that reduction of tumor cells. As for retroperitoneal lymph node removal of the therapeutic value can not be determined.

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