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卵巢、输卵管或腹膜上皮性癌生存者的管理方法概述

Author
Linda R Duska, MD
Section Editors
Larissa Nekhlyudov, MD, MPH
Barbara Goff, MD
Don S Dizon, MD, FACP
Deputy Editors
Sadhna R Vora, MD
Sandy J Falk, MD, FACOG
Translators
高艳娥, 主任医师，教授

引言

尽管卵巢、输卵管及腹膜上皮性癌[统称为上皮性卵巢癌(epithelial ovarian carcinoma, EOC)]是妇科癌症中最致命的类型，但截至2014年，仅美国就将近有200,000名EOC生存者[1]。尽管约80%的患者在初始治疗后进入疾病缓解期，但大部分EOC生存者仍带病生存；早期和晚期EOC女性的复发率分别为25%和80%[2,3]。然而，据报道EOC长期生存者的5年和10年生存率分别为43%和33%[4]。由于发病时年龄较大或EOC的手术治疗，大部分生存者会是绝经后的女性。

本专题将总结EOC生存者的管理方法。就这个目的而言，我们仅限于讨论已完成初始治疗且没有疾病残留证据的EOC生存者，因为这些是最有可能在协作治疗的情况下被其初级保健医护人员接诊的患者。相比之下，复发性EOC女性的需求和治疗取决于她们是否正在接受积极的治疗，这将单独讨论。 (参见下文‘协作治疗’和“早期(Ⅰ和Ⅱ期)上皮性卵巢癌、输卵管癌或腹膜癌的辅助治疗”，关于‘复发疾病的治疗’一节)

有关EOC的诊断、分期和治疗的更多信息参见其他专题。 (参见“上皮性卵巢、输卵管及腹膜癌的概述”)

卵巢癌的生存问题

关于卵巢癌生存问题的研究不及其他癌症的生存问题研究地透彻。这可能由于EOC女性的整体预后较差，以及与其他癌症(如，子宫内膜癌或乳腺癌)患者相比，EOC受累的人群数量较少。然而，生存相关问题很重要，因为这除了影响患者的生存质量(quality of life, QOL)，也可能影响患者的生存结局[5,6]。例如，美国妇科肿瘤协作组(Gynecology Oncology Group, GOG)进行的一项随机试验(GOG 152)中，分别在治疗的第3和第6个周期以及开始治疗后的第6个月和第12个月评估了患者的生存质量[5]。该研究发现基线生存质量分值与总生存期显著相关。另外，尽管治疗过程中生存质量下降，但在开始治疗后的第6个月和第12个月，生存质量显著改善。

初始治疗概述

治疗方法取决于就诊时疾病的临床分期：

                              

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Literature review current through: 2017-06 . | This topic last updated: 2016-07-12.
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