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惡性卵巢腫瘍의 臨床病理學的 考察

Clinico-Pathological Observation on Malignant Ovarian Tumors

대한산부인과학회지 1968년 11권 12호 p.1 ~ 11
金顯燦/Kim, Hyun Chan

Abstract


The results obtained areas follows:
1) The incidence of malignant ovarian tumors of all ovarian tumors was 13,71%.
2) Age distribution of malignant ovarian tumors was concentrated on the ages between 45-49 (average 42 years).
3) The primary sterility rate and nulliparity rate of malignant´ ovarian tumors were 15,5%c and 5,4%, respectively.
4) About 2/3,(65.2%) of all malignant ovarian tumors. had regular menstrual cycle and 34,7,0, of them had irregularity to some extent. Dysmenorrhea and menometrorrhagia were 15. 1 % - and 10,4%, respectiveiy. The- later were all belonged to granulosa cell carcinoma.
5) As to the .subjective symptoms of all malignant tumors,palpable mass in the lower abdomen, regardless the presence of ascites, was noticed in 86%, lower abdominal pain in 52, 6%0, G-I troubles in 24, 7% and menstruall disorder in 21,50/c,
6) Palpable´lnasses were observed in 96,7%, ascites ;´ in 31,1%, anemic state in 15,0% and cachexia in 13,9%, in, objective findings.
7) Cytological examination with vaginal or cervical discharge and ascites were positive in 3.7% and 54,1% (over Class III), respectively. The associated malignancy of endometnurn was found in 8,3% of preoperative diagnostic curettage and surgical, specimen.
8) The macroscopic and microscopic bilaterality were in 28,5% and 40%, respectively.
9) According. to the International Classification of the Clinical stage, Stage, I in 32,2;6, Stage II in 16.7%, Stage III 23.4%, Stage IV in 2.2% and Special: category in 25.5%.
10) Regarding the macroscopic nature of the gross specimen, cystic variety was more comn (55.7%).12.0% of them were difficult to interpret its nature, whether benign or malignum however, the cut surface revealed that the purely cystic tumors were only in 7.1%
11) According to the Novak´s Histopathological Classification, serous, cystaderiocarcinoma was in 34%, seudomueinous adenocarcinoma in 32%, granulosa cell tumor in 12.7%, primary solid carcinoma in 10%, teratoma in 4.2%, sarcoma in 2.8% dysger-minoma.and matastatic Krukenberg tumor in 2.8%.
12) Regarding the relationship between the clinical stage and histopathological type, the primary solid adenocarcinoma and serous cystadenocarcinoma seemed to be found in more advanced stages than pseudomucinous-cystadenocarcinoma. The granulosa cell tumor seemed to be proportionately distributed in all stages.
13) Treatment was surgical primarily and the principle of it was total or subtotal hysterectomy with bilateral salpingo-oophorectomy with or without omentomy. Adjuvant treatments, ThioTepa and Co60 external irradiation, were applied to some of the operated cases.
14) -Among the 43 cases, completely resectable at initial surgery, the sign of tumor within 1. 2 and 3 years were in 16.3%, 22.3% and 26.6% respectively. The effects of adjuvant treatmentt were hard to interpret but 7 cases responded to Co6° external irradiation more or less.
15) The 3 year survival rate was 36.3% of 33 operated cases and the presumed 5 year susvival rate seemed to -be 26.3% of 19 operated cases.

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