| Objective:To compare the clinical efficacy and perioperative morbi-dity between primary debulking surgery(PDS)and interval debulking surgery(IDS)in patients with stage ⅢC epithelial ovarian cancer(EOC).It provides reference for clinical treatment.Methods: A retrospective analysis was made of 205 patients with stage ⅢC EOC diagnosed in Hunan Cancer Hospital from January 2012 to January 2014.According to the different therapeutic regimen,the collected patients were divided into NACT-IDS group and PDS group.NACT-IDS group have eighty one patients who received platinum-based 2-3 courses of combined chemotherapy before operation and 2-3 weeks later underwent cytoreductive surgery(CS).PDS group have One hundred and fortyfour patients who received chemotherapy after CS.The general condition of the first treatment,operation,satisfactory tumor reduction rate,organ injury,postoperative complications,disease progression-free survival time(PFS)and overall survival time(OS)of the two groups were analyzed.The 3-year survival rate and 5-year survival rate were statistically analyzed.All data were statistically analyzed by spss24.0,mean±standard deviation was used to describe the distribution of measurement data,independent sample ttest was used to compare the differences between groups,and frequency and composition ratio were used to describe the distribution of counting data.Chisquare test was used to compare the differences between groups,Kaplan-Meier method was used for survival analysis,logrank method was used to compare the differences between groups and the survival curve was drawn.There was significant difference between the two groups(P< 0.05).Result : 1.The age of patients in the NACT-IDS group was54.4±8.09 years old,and the average age of patients in the PDS group was 50.93±8.4 years old,both of which were between 50 and 60 years old,consistent with the epidemiological survey results.2.The primary lesions in the NACT-IDS group were larger than those in the PDS group(P < 0.001).3.There were no statistically significant differences in BMI,pathological type and pathological grading between the two groups(P >0.05).4.NACT-IDS group resulted completely debulked(residual disease<1cm)was higher than that in PDS group(P < 0.05).5.Intraoperative blood loss,length of stay and ascites in the PDS group were all greater than those in the NACT-IDS group(P < 0.001).The operation time of PDS group was longer than that of NACT group(P > 0.05).6.The incidence rate of intraoperative intestinal repair,partial intestinal resection and urinary system injury in the PDS group was higher than that in the NACT-IDS group(P < 0.05).Other organ injuries in the PDS group were higher than those in the NACT-IDS group(P >0.05).7.The morbidity of anemia and intestinal obstruction in PDS group was higher than that in NACT-IDS group(P<0.05).The incidence of pneumonia,pelvic infection and venous thrombosis in the PDS group was higher than that in the NACT-IDS group(P> 0.05).8.The total effective rate was 71.5%(58/81)in the NACT-IDS group and 79%(98/124)in the PDS group(P > 0.05).9.PFS and OS,3-year survival rate and 5-year survival rate in the PDS group were higher than those in the NACT-IDS group(P < 0.05).Conclusion:1.Compared with PDS,NACT-IDS can improve the intraoperative situation,improve the satisfactory tumor shrinkage rate of CS,reduce intraoperative blood loss,shorten the operation time and the length of hospital stay,and improve the quality of life.2.In the NACT-IDS group patients,By contrast,the incidence of intraoperative organ injury and postoperative complications was lower.3.The PFS and OS of patients with NACT-IDS were worse thanthose of patients with PDS.The use of NACT-IDS should be strictly controlled in patients with advanced ovarian cancer who could not tolerate primary debulking surgery or who could not obtain satisfactory reduction of tumor under high tumor load. |
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