卵巢癌遠端轉移的擴散型態

Metastatic patterns of ovarian cancer

根據台灣衛福部於民國 100 年的的統計報告，卵巢癌是女性癌症發生率的第四名，於民國 100 內全國總共發生1242 例新病患（第一名為乳癌，新個案發生率為 10056 例，第二名為子宮內膜癌，新個案發生率為1722 例，第三名為子宮頸癌，新個案發生率為 1673 例。75%的病患在第一次診斷時就已經是第三期或是第四期，僅25%被診斷為第一期或是第二期。卵巢癌的擴散或是復發和其他癌症不太一樣的地方是幾乎都發生在腹膜腔內，而轉移到其他器官的機會並不高。正因為如此，常會有卵巢癌病患癌細胞已有遠端轉移，但是卻被疏忽了。本文專門在介紹卵巢癌可能會轉移到哪些組織或器官，討論轉移的機會，提醒你如何注意，並適時告知你的醫師。

Among the gynecological malignancies, ovarian cancer is the leading cause of mortality in developed countries with estimated 225,500 new cases and 140,200 deaths worldwide. In the United States, it is estimated that 22,240 women will be diagnosed with ovarian cancer in 2013 among whom 14,030 will die. The majority of ovarian cancer is of epithelial origin. The major histological subtypes of epithelial ovarian cancer include: serous, mucinous, endometrioid, clear cell, undifferentiated and unclassified. Ovarian cancer usually remains confined to the peritoneal cavity at initial presentation. Although the intraperitoneal route of dissemination is considered the most common, ovarian cancer may also metastatize through the lymphatic channels and the hematogenous route. Distant metastases may occur at the time of diagnosis of ovarian cancer (stage IV disease) or can arise during the evolution of the disease. They are usually associated to widespread disseminated disease and poor performance status; the effects of these rare metastases are devastating and survival is usually very dismal. The aim of this mini-review was to discuss the routes and organs/sites that are involved in the distant metastases of ovarian cancer. Potential treatment and outcomes are also covered for some organs.