4回の再発腫瘍摘出術を経て10年以上の長期生存を得ている卵巣癌Ⅲc期の1例  [in Japanese] A Survivor of More than 10 Years with Stage 3c Ovarian Carcinoma who Received Recurrent Tumor Resection 4 Times  [in Japanese]

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Author(s)

    • 西田 恵子 Nishida Keiko
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 松本 光司 Matsumoto Koji
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 佐藤 豊実 Satoh Toyomi
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 中村 優子 Nakamura Yuko
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 櫻井 学 Sakurai Manabu
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 中尾 砂理 Nakao Sari
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 八木 洋也 Yagi Hiroya
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 越智 寛幸 Ochi Hiroyuki
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 小貫 麻美子 Onuki Mamiko
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba
    • 川崎 彰子 Kawasaki Akiko
    • 筑波大学医学医療系産科婦人科学 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba

Abstract

卵巣癌Ⅲc期に対し初回治療として腹式単純子宮全摘+両側付属器摘出+骨盤内リンパ節廓清+傍大動脈リンパ節廓清+大網部分切除を行い,肉眼的完全摘出を達成した後パクリタキセルとカルボプラチンの併用(TC)療法を6コース施行し初回治療終了.1年10カ月後に右小脳4cm大の再発腫瘍を認め摘出術後放射線療法施行.その3年後,右閉鎖節領域に単発再発し摘出術を行ったが骨盤壁浸潤を有し残存の可能性が危惧された.TC療法を5コース施行したが1年後に同部位に再発,再度摘出術とその前後にTC療法を2コースずつ行い,外照射56 Gyを追加した.更に1年9カ月後,右傍結腸溝に単発の再発腫瘍を認めた.照射野外であり4回目の腫瘍摘出術を行う方針とし術前にTC療法を2コース施行,術後は化学療法を3コース追加した.<BR>初回治療から10年5カ月,4回目の再発手術から1年を経過し5度目の再発の兆候はない.

Radical surgery, followed by chemotherapy using paclitaxel and carboplatin (TC) therapy, was performed on a patient with Stage Ⅲc ovarian carcinoma as primary treatment. The first recurrent tumor was developed in the cerebellum 1 year and 10 months after primary treatment. The patient received surgery and adjuvant irradiation. The second recurrent tumor was detected in a field of right obturator lymph node 3 years after previous treatment. The patient received surgical resection of the tumor and 5 cycles of TC therapy after the resection. One year after the last chemotherapy, the third recurrent tumor appeared in the same field as the second recurrence. The patient received re-resection, TC therapy before and after re-resection, and 56 Gy of focused irradiation. The 4<sup>th</sup>, solitary, recurrent tumor grew in the right paracolic sulcus 1 year and 9 months after last treatment. The patient underwent 2 courses of chemotherapy before tumor resection, a 4<sup>th</sup> surgical resection of the recurrent tumor, and 3 courses of chemotherapy after surgery. She lives with no evidence of disease 10 years 5 months after primary treatment (1 year after the 4<sup>th</sup> surgery of the recurrent tumor).

Journal

  • Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)

    Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 39(5), 1007-1011, 2014

    Japanese College of Surgeons

Codes

  • NII Article ID (NAID)
    130005106034
  • Text Lang
    JPN
  • ISSN
    0385-7883
  • Data Source
    J-STAGE 
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