卵巢癌随访与健康管理中国专家共识(2026年版)

Chinese Journal of Practical Gynecology and Obstetrics ›› 2026, Vol. 42 ›› Issue (8) : 841-848.

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Chinese Journal of Practical Gynecology and Obstetrics ›› 2026, Vol. 42 ›› Issue (8) : 841-848. DOI: 10.19538/j.fk2026080114

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[1]
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. DOI:10.3322/caac.21660.
[2]
Li M, Hu M, Jiang L, et al. Trends in cancer incidence and potential associated factors in China[J]. JAMA Netw Open, 2024, 7(10):e2440381. DOI:10.1001/jamanetworkopen.2024.40381.
[3]
Zachou G, El-Khouly F, Dilley J. Evaluation of follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment[J]. Cochrane Database Syst Rev, 2023, 8(8):CD006119. DOI:10.1002/14651858.CD006119.pub4
[4]
国家癌症中心, 国家肿瘤质控中心卵巢癌质控专家委员会. 中国卵巢癌规范诊疗质量控制指标(2022版)[J]. 中华肿瘤杂志, 2022, 44(7):609-614. DOI:10.3760/cma.j.cn112152-20220418-00268.
[5]
Woopen H, Keller M, Zocholl D, et al. Side effects from cancer therapies and perspective of 1044 long-term ovarian cancer survivors-results of expression VI-Carolin meets HANNA-Holistic analysis of long-term survival with ovarian cancer:the international NOGGO,ENGOT,and GCIG survey[J]. Cancers (Basel), 2023, 15(22):5428. DOI:10.3390/cancers15225428.
The aim of this survey was to increase the knowledge on the characteristics and health concerns of long-term survivors (LTS; survival > 5 years) after ovarian cancer in order to tailor follow-up care. This international survey was initiated by the NOGGO and was made available to members of ENGOT and GCIG. The survey is anonymous and consists of 68 questions regarding sociodemographic, medical (cancer) history, health concerns including distress, long-term side effects, and lifestyle. For this analysis, 1044 LTS from 14 countries were recruited. In total, 58% were diagnosed with FIGO stage III/IV ovarian cancer and 43.4% developed recurrent disease, while 26.0% were receiving cancer treatment at the time of filling in the survey. LTS who survived 5–10 years self-estimated their health status as being significantly worse than LTS who survived more than 10 years (p = 0.034), whereas distress also remained high 10 years after cancer diagnosis. Almost half of the cohort (46.1%) reported still having symptoms, which were mainly lymphedema (37.7%), fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal problems (16.6%), and memory problems (15.5%). Almost all patients (94.2%) regularly received follow-up care. Specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention should be offered beyond the typical five years of follow-up care.
[6]
Lanceley A, Berzuini C, Burnell M, et al. Ovarian cancer follow-up:a preliminary comparison of 2 approaches[J]. Int J Gynecol Cancer, 2017, 27(1):59-68. DOI:10.1097/igc.0000000000000877.
The aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer.One hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group.There was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, -0.03 to -0.001; PSQ-III P = 0.002; 95% confidence interval, -0.003 to -0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07).Individualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.Trial registration number is ISRCTN59149551.
[7]
Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ, 2008, 336(7650):924-926. DOI:10.1136/bmj.39489.470347.AD.
[8]
Werner TL, Zsiros E, Behbakht K, et al. NCCN Guidelines® Insights:Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer,Version 3.2024[J]. J Natl Compr Canc Netw, 2024, 22(8):512-519. DOI:10.6004/jnccn.2024.0052.
[9]
孔北华, 刘继红, 黄鹤, 等. 卵巢癌PARP抑制剂临床应用指南(2022版)[J]. 肿瘤综合治疗电子杂志, 2022, 8(3):64-72.
[10]
Rustin GJS, Vergote I, Eisenhauer E, et al. Definitions for response and progression in ovarian cancer clinical trials incorporating RECIST 1.1 and CA125 agreed by the Gynecological Cancer Intergroup (GCIG)[J]. Int J Gynecol Cancer, 2011, 21(2):419-423. DOI:10.1097/IGC.0b013e3182070f17.
[11]
中国医师协会微无创医学专业委员会妇科肿瘤学组, 中国抗癌协会中西整合卵巢癌专业委员会. 铂敏感复发性卵巢癌诊治中国专家共识(2023年版)[J]. 中国实用妇科与产科杂志, 2023, 39(9):935-942.DOI:10.19538/j.fk2023090117.
[12]
田东立, 李芳梅, 芦恩婷, 等. 铂耐药复发性卵巢癌诊治中国专家共识(2025年版)[J]. 肿瘤学杂志, 2025, 31(2):83-93.
[13]
Sanft T, Day A, Ansbaugh S, et al. NCCN Guidelines® Insights:Survivorship,Version 1.2023[J]. J Natl Compr Canc Netw, 2023, 21(8):792-803. DOI: 10.6004/jnccn.2023.0041.
[14]
Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer:ASCO guideline update[J]. J Clin Oncol, 2023, 41(16):3063-3071.DOI:10.1200/JCO.23.00294.
[15]
Heydari A, Manzari ZS, Pouresmail Z. Nursing intervention for quality of life in patients with ostomy:A systematic review[J]. Iran J Nurs Midwifery Res, 2023, 28(4):371-383. DOI:10.4103/ijnmr.ijnmr_266_22.
Ostomy-related challenges in everyday life may negatively affect patients' Quality of Life (QL), even long after ostomy surgery. Nurses provide care interventions that may have a significant effect on the patients' QL. Therefore, the purpose of the present study was to determine evidence of effective nursing interventions on the QL of patients with an ostomy.A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. English articles published from 2000 to 2021 were identified and retrieved from PubMed, Medscape, MedlinePlus, ScienceDirect, Web of Science, Scopus, Wiley Online Library, ProQuest, ClinicalKey, SAGE, IRCT, and Cochrane. We assessed all included studies (18 articles) using the JBI Critical Appraisal Checklist.Interventions reviewed in the study were categorized based on intervention, content of nursing intervention, training method, and target group of the nursing intervention. The nursing interventions involved natural treatments, self-care, and psychological support for patients. The training methods used in the studies included demonstration and lecture, mixed media presentation including PowerPoints, and Internet tools such as WeChat Applications. Some interventions were only presented to patients, caregivers, caregivers and patients together, or peer patients.According to the results of the present study, it is suggested that a regular care plan be used with the participation of families and patients from pre-operational to discharge along with nurses' follow-ups and home care to promote the QL. A combination of self-care and psychological education can promote these patients' QL.Copyright: © 2023 Iranian Journal of Nursing and Midwifery Research.
[16]
Bentivegna E, Fruscio R, Roussin S, et al. Fertility-sparing surgery in epithelial ovarian cancer:a systematic review of oncological issues[J]. Ann Oncol, 2016, 27(11):1994-2004. DOI: 10.1093/annonc/mdw311.
Since the last two decades, the feasibility of fertility-sparing surgery (FSS) in early-stage epithelial ovarian cancer (EOC) has been explored by several teams and is reconsidered in this systematic review undertaken using the PRISMA guidelines. Borderline ovarian tumours and non-EOCs were excluded. This review comprises 1150 patients and 139 relapsing patients reported by 21 teams. This conservative treatment can be safely carried out for stage IA and IC grade 1 and 2 disease and stage IC1 according to the new FIGO staging system. Nevertheless, the number of patients reported with grade 2 disease is too small to definitively confirm whether FSS is safe in this subgroup. For patients with 'less favourable' prognostic factors (grade 3 or stage IC3 disease), the safety of FSS could not be confirmed, but patients should be informed that radical treatment probably may not necessarily improve their oncological outcome, because the poorest survival observed could be related to the natural history of the disease itself and not specifically to the use of conservative therapy. FSS could probably be considered in stage I clear-cell tumours but should remain contraindicated for stage II/III disease (whatever the histologic subtype). As the disease stage and the histologic data (tumour type and grade) are crucial to patient selection for this treatment, this implies careful and mandatory complete surgical staging surgery in this context and a pathological analysis (or review) of the tumour by an expert pathologist.© The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
[17]
Saeaib N, Peeyananjarassri K, Liabsuetrakul T, et al. Hormone replacement therapy after surgery for epithelial ovarian cancer[J]. Cochrane Database Syst Rev, 2020, 1(1):CD012559. DOI:10.1002/14651858.CD012559.pub2.
[18]
Deli T, Orosz M, Jakab A. Hormone replacement therapy in cancer survivors-review of the literature[J]. Pathol Oncol Res, 2020, 26(1):63-78. DOI:10.1007/s12253-018-00569-x.
[19]
国家卫生健康委员会, 国家中医药管理局. 进一步改善护理服务行动计划(2023-2025年)[J]. 中国护理管理, 2023, 23(7):961-963. DOI:10.3969/j.issn.1672-1756.2023.07.001
[20]
Hansen JM, Nagle CM, Ibiebele TI, et al. A healthy lifestyle and survival among women with ovarian cancer[J]. Int J Cancer, 2020, 147(12):3361-3369. DOI:10.1002/ijc.33155.
Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle prediagnosis and postdiagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self‐reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n = 678) and after completing primary treatment (n = 512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all‐cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95% CI: 0.59‐1.04), however, the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95% CI: 0.40‐0.93; P‐trend =.02). Current smoking, particularly postdiagnosis, was associated with higher mortality (HR 1.68, 95% CI: 1.17‐2.42; HR 2.82, 95% CI: 1.29‐6.14, for prediagnosis and postdiagnosis smoking, respectively), but women who quit after diagnosis had survival outcomes similar to nonsmokers (HR 0.99, 95% CI: 0.57‐1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95% CI: 0.39‐0.92; P‐trend =.02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis.
[21]
Yeoh SA, Webb S, Phillips A, et al. Psychosocial interventions for ovarian cancer survivors:A systematic review[J]. Psychooncology, 2024, 33(1):e6280. DOI:10.1002/pon.6280.
Ovarian cancer survivorship is complex and is associated with greater symptom burden, fear of reoccurrence, sexual dysfunction, lower quality of life and heightened existential distress in contrast to other cancers. This systematic review aimed to investigate the effectiveness for, and perspective of, psychosocial interventions encompassing psychological, social, and emotional support, tailored to, or involving ovarian cancer survivors at all stages of disease.Adhering to the PRISMA-SR statement guidelines, a systematic search was conducted across PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, Cochrane Library databases, Google, and Google Scholar. Two reviewers independently undertook a two-stage screening process. The Mixed Methods Appraisal Tool was utilised to assess the methodological quality of included studies. Data were extracted using customised data extraction tools and narratively synthesised.Thirteen studies were included in this review. Generally positive effects of psychosocial interventions were observed across a range of outcome domains (meaning enhancing, cognitive, social, emotional, and cancer-specific). However, the characteristics of interventions and outcome measures varied across studies. Psychoeducational interventions were identified as the most common psychosocial approach, while Acceptance and Commitment Therapy showed promise in addressing the disease's high symptom burden. Women's perspectives of psychosocial interventions were described as "useful" and promoted positive self-regard.While the evidence base largely support positive effects of psychosocial interventions for ovarian cancer survivors, this finding is constrained by heterogeneity of interventions and modest gains. Future research may explore the standardisation of psychosocial interventions for this demographic, investigating its effects on less explored but prevalent concerns among ovarian cancer survivors such as fear of cancer recurrence and sexual dysfunction.© 2024 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
[22]
Kann BH, Hosny A, Aerts HJWL. Artificial intelligence for clinical oncology[J]. Cancer Cell, 2021, 39(7):916-927. DOI:10.1016/j.ccell.2021.04.002.
Clinical oncology is experiencing rapid growth in data that are collected to enhance cancer care. With recent advances in the field of artificial intelligence (AI), there is now a computational basis to integrate and synthesize this growing body of multi-dimensional data, deduce patterns, and predict outcomes to improve shared patient and clinician decision making. While there is high potential, significant challenges remain. In this perspective, we propose a pathway of clinical cancer care touchpoints for narrow-task AI applications and review a selection of applications. We describe the challenges faced in the clinical translation of AI and propose solutions. We also suggest paths forward in weaving AI into individualized patient care, with an emphasis on clinical validity, utility, and usability. By illuminating these issues in the context of current AI applications for clinical oncology, we hope to help advance meaningful investigations that will ultimately translate to real-world clinical use.Copyright © 2021 Elsevier Inc. All rights reserved.
[23]
Laios A, Theophilou G, De Jong D, et al. The future of AI in ovarian cancer research:the large language models perspective[J]. Cancer Control, 2023, 30:10732748231197915. DOI:10.1177/10732748231197915.
[24]
Cai Y, Zhao R, Zhao H, et al. Exploring the use of ChatGPT/GPT-4 for patient follow-up after oral surgeries[J]. Int J Oral Maxillofac Surg, 2024, 53(10):867-872. DOI:10.1016/j.ijom.2024.04.002.
[25]
李鹤, 章梅云, 俞素芬, 等. 智能化癌性疼痛患者出院随访系统的构建及应用[J]. 中华护理杂志, 2024, 59(13):1562-1567.
目的 构建智能化癌性疼痛患者出院随访系统并进行应用,旨在为提高医院随访效率,促进患者居家疼痛管理提供借鉴。 方法 智能化癌性疼痛患者出院随访系统包括患者自我报告平台和管理员操作平台2个平台;管理员操作平台由工作台模块、随访计划模块、随访结果模块、健康宣教模块和数据统计模块5大模块构成。2022年1月该系统在临床正式应用,分析系统的应用情况并比较系统应用前(2020年1月—2021年12月)与应用后(2022年1月—2023年11月)患者随访完成率、用药依从率、中重度疼痛发生率和对疼痛控制的满意度等。 结果 该系统目前已在医院95个癌性疼痛相关病房推广应用。2022年1月—2023年11月,应随访4 248人次,实际完成随访4 127人次,随访完成率为97.2%,随访及时完成率为94.9%,系统自动随访率为40.1%,患者异常情况报告率为31.9%,患者异常情况报告及时处理率为89.1%;系统应用后癌性疼痛患者随访完成率提高,差异具有统计学意义(P<0.001);系统应用后患者用药依从率由86.9%上升至91.0%、中重度疼痛发生率由6.8%下降至5.2%、对疼痛控制的满意度由81.0%上升至83.5%,差异均具有统计学意义(P<0.05)。 结论 应用智能化癌性疼痛患者出院随访系统能有效提高癌性疼痛患者出院随访率,促进患者居家癌性疼痛的管理。

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Funding

National Medical High-Level Talent Program - National Outstanding Young Physician
Important New Medical Directions Funding Project,University of Science and Technology of China—Special Fund for Coordinating the Construction of World-Class Universities and First-Class Disciplines(YD9110002049)
Anhui Province Natural Science Foundation—General Project(2408085MH208)
Anhui Key Laboratory of Novel Biomedical Imaging and Intelligent Processing Open Fund(24YGXT001)
Anhui Province Clinical Key Specialty Fund(2022sjlczdzk)
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