| Objective To compare and analyze the treatment of primary debulking surgery(PDS)combined with neoadjuvant chemotherapy(NACT)combined with interval debulking surgery(IDS).Therapeutic effect of advanced epithelial ovarian cancer.Methods A retrospective analysis of the clinical data of gynecological pathology diagnosed in the general hospital of Ningxia Medical University between 2010.01 and2015.01 was performed.The clinical data of 102 patients with epithelial ovarian cancer in the FIGO stage(2006 edition)were stage Ⅲ~Ⅳ 52 Patients with primary debulking surgery combined with chemotherapy(PDS group)and 50 patients with neoadjuvant chemotherapy combined with interval debulking surgery(IDS group).The general conditions,intraoperative situation,postoperative complications,average length of hospital stay,short-term efficacy,adverse reactions,5-year progression-free survival,and overall survival were compared between the two groups of patients.Results(1)Comparison of the general conditions of the two groups: There was no significant difference in general information such as age,FIGO stage,case type,degree of differentiation,and chronic comorbidity between the two groups(P>0.05);(2)Comparison of intraoperative conditions between the two groups: The average operation time in the PDS group was(121.83±37.38)minutes,and the average operation time in the IDS group was(103.56±42.06)minutes.The difference between the two groups was statistically significant(P < 0.05).The average intraoperative blood loss in the PDS group was(360.58 ±306.74)mL,the average intraoperative blood loss in the IDS group was(189.40±134.52)mL,and the difference between the two groups was statistically significant(P<0.05);the average transfusion in the PDS group was(325.00 ± 495.42)mL,The average blood transfusion volume in the IDS group was(100.00±221.31)mL,and the difference between the two groups was statistically significant(P<0.05).The average length of stay in the PDS group was(13.10 ± 4.32)days,and the average length of stay in the IDS group was(11.42 ±3.51)d.The difference between the two groups was statistically significant(P < 0.05).(3)Comparison of postoperative complications between the two groups of patients: there was no significant difference in postoperative complications between the two groups of patients(P > 0.05).(4)Comparison of adverse reactions during the treatment of two groups of patients: In PDS group,there were 42 cases(80.8%)of nausea and vomiting of grade I and below,10 cases(19.2%)of grades II-III.There were 41 cases(78.8%)of bone marrow suppression of grade I and below,11 cases(21.2%)of grade II-III.There were 44cases(84.6%)of liver and kidney damage of grade I and below,8 cases(15.4%)of grade II-III;In IDS group,there were 47 cases(94.0%)of nausea and vomiting of grade I and below,3 cases(6.0%)of grades II-III.There were 47 cases(94.0%)of bone marrow suppression of grade I and below,3 cases(6.0%)of grade II-III.There were 49 cases(98.0%)of liver and kidney damage of grade I and below,1 cases(2.0%)of grade II-III.The above indexes were significantly different between the two groups of patients(P<0.05);there was no statistics on adverse cardiac toxicity in the two groups of patients.Significance(P>0.05).(5)Comparison of short-term efficacy: The total effective rate in the PDS group was 63.4%,of which 8 cases(15.4%)were completely relieved,and 25 cases(48.0%)were partially relieved;the total effective rate was 82% in the IDS group,with complete symptoms There were 12 cases(24.0%)in remission and 29 cases(58.0%)in partial remission.The difference between the two groups was statistically significant(P<0.05).(6)Comparison of the prognosis of the two groups of patients: The 5-year progression-free survival and overall survival of the patients in the PDS group and the IDS group were not statistically different.Conclusion Compared with the primary debulking surgery,neoadjuvant chemotherapy for ovarian cancer can significantly reduce the tumor burden,reduce the occurrence of complications such as bleeding during interval debulking surgery,and improve the safety and quality of life after surgery.However,it did not significantly improve the survival of patients. |
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