卵巢癌的诊断和治疗(医大讲课) .ppt

Post-Therapy Surveillance Follow-up after therapy in ovarian cancer is poorly defined. At the present time there is no definitive test for detecting the presence of microscopic recurrent epithelial ovarian cancer For this reason there remains significant controversy as to what constitutes optimal posttherapy surveillance. * ppt课件 Post-Therapy Surveillance Screening modalities: 1. Pelvic Examination 2. CA 125 (44% sensitivity, 96% specificity, 65% accuracy) 3. Ultrasound (20%-89% sensitivity, 75%-100% specificity) 4. Second-look laparotomy 5. CT scan (44% sensitivity, 86% specificity, 63% accuracy) 6. MIR imaging. 6. Position emission tomography (PET) (83% sensitivity, 80% specificity, 82% accuracy) * ppt课件 * ppt课件 卵巢癌的临床分期 * ppt课件 卵巢癌I期和II期 Ia期 Ic 期 腹水阳性 或 Ib期 I期 II期 IIa 期 IIb 期 IIc 期 * ppt课件 卵巢癌III期和IV期 Beecham Sevigne, M閙ento de Stadification des Principales Tumeurs Solides III期 种植性肝转移 腹腔腹膜转移 肝实质性转移 恶性胸膜细胞 前锁骨淋巴结 IV期 * ppt课件 * ppt课件 * ppt课件 * ppt课件 * ppt课件 * ppt课件 * ppt课件 卵巢癌的治疗: 手术 (I) DeVita et al. Cancer: Principles Practice of Oncology.1993 全腹腔探查 和活检 网膜 几乎所有的病人进 行全子宫、双侧输 卵管及网膜切除术 * ppt课件 * ppt课件 * ppt课件 * ppt课件 Lymph nodes metastasis and retroperitonal lymphadenectomy in ovarian cancer Lymphatic pathway is an important route of metastasis in ovarian cancer. The overall incidence of retroperitoneal positive nodes 54.3% The incidence of positive pelvic nodes 46.7% positive para-aortic nodes 37.5% Both aortic and pelvic nodes positive 48.7% * ppt课件 * ppt课件 * ppt课件 * ppt课件 * ppt课件 Intestinal metastasis and operation in ovarian cancer Rectosigmoid involved 95.2% Metastasis to small bowel 41.9% Superficial and serosal invasion 64.5% Complete or optimal resection 74.2% resection of the bowel 31.2% Colostomy 9.8% 27.4% s