初次肿瘤细胞减灭术与中间性肿瘤细胞减灭术对晚期卵巢癌患者 远期生存的影响真实世界临床研究.

To compare the impact of primary debulking surgery (PDS) and interval debulking surgery (IDS) on the long-term survival of patients with advanced ovarian cancer. Patients with advanced epithelial ovarian cancer (stage III-IVB) who underwent surgery (PDS/IDS) in the Gynecology Department of The First Affiliated Hospital of University of USTC from January 2018 to June 2018 were collected. The two types of surgery were compared in terms of survival time (OS) and incidence of serious surgical complications. Kaplan-Meier method was used to analyze the survival curve, log-rank test was used to compare the survival differences, and Cox proportional hazards regression model was used to analyze the risk factors affecting survival. A total of 76 patients were included, including 24 cases in the IDS group, and 52 cases in the PDS group. There were no statistically significant differences between the two groups in terms of age, nutritional score, preoperative hemoglobin (Hb) levels, histopathological types, clinical stages, etc(P>0.05). The intraoperative bleeding volume in the IDS group was significantly lower than that in the PDS group (1045.83± 981.91 mL vs 1628.85± 1168.72 mL, P<0.01). The incidence of serious surgical complications in the IDS group was significantly lower than that in the PDS group (12.5% vs 36.5%, P<0.05). During follow-up, there were 9 deaths in the IDS group, and 16 deaths in the PDS group. The median OS in the IDS group was 47.0 months, and the median OS in the PDS group was 38.0 months, and there was no significant difference in OS between the two groups (P=0.17). Multivariate Cox regression analysis showed that intraoperative bleeding volume(HR=1.001, 95%CI=1.000-1.002, P=0.03) and severe surgical complications (HR=2.345,95%CI=1.123-4.902, P=0.02) were independent risk factors affecting OS, while the operation type (PDS/IDS) was not an independent risk factor affecting OS (HR=0.667,95% CI=0.302-1.473, P=0.32). In patients with advanced ovarian cancer, IDS compared with PDS can reduce intraoperative bleeding volume and the incidence of serious surgical complications, but has no significant effect on long-term survival. Intraoperative bleeding volume and severe surgical complications are independent risk factors for long-term survival, and should be avoided. [ABSTRACT FROM AUTHOR]