Liu Sui, Liu Ji-Hong, Huang He, Peng Xiao-Ping, Wang Yuan-Mei
Department of Gynecology Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Ai Zheng. 2003 Nov;22(11):1197-200.
BACKGROUND & OBJECTIVE: Advanced ovarian cancer shows a high recurrence and poor survival rate. It is important to identify the risk factors for the recurrence of ovarian cancer, due to the lack of reliable methods for the detection of early disease. This study was designed to explore the risk factors for the recurrence of epithelial ovarian cancer.
Factors that might be related to the recurrence of 109 epithelial ovarian cancer patients including age, pathological type, FIGO stage, operation type, chemotherapy regimen, neoadjuvant chemotherapy, postoperative chemotherapy cycles, first operation status, and size of residual tumor were analyzed by logistic regression model using SPSS 10.0 statistical software.
Of 109 patients with ovarian cancer, 36 (33%) relapsed after a combination of surgery and chemotherapy, and the median recurrence-free interval was 19 months. The 5-year survival rates were 62.7% and 43.3% for the 109 patients and the recurrent patients, respectively. The survival rates of pelvic recurrence (50.1%) and extra-pelvic recurrence (36.1%) were not statistically different. Univariate analysis showed that the risk of recurrence in mucous adenocarcinoma or FIGO stage I patients were lower than that of other pathology type or FIGO stage (beta=-1.565 and -1.799,P=0.0120 and 0.026 ) while it was higher in the patients given above 8 cycles chemotherapy than those given 1-4 or 6-8 cycles(beta=-3.591 and -1.500,P< 0.001 and =0.038). Multivariate analysis showed that histological type, FIGO stage and postoperative chemotherapy cycles had remarkable influence on the relapse of epithelial ovarian cancer independently(RR=3.473, 4.713, and 6.140, respectively, P< 0.05).
Histological type, FIGO stage, and postoperative chemotherapy cycles influence the recurrence of epithelial ovarian cancer. Since FIGO stage is a remarkable risk factor for the recurrence, early diagnosis should be the key point to decrease it. Reasonable chemotherapy plan is essential for the therapy of ovarian cancer, but excessive chemotherapy is not good for effectiveness.
晚期卵巢癌复发率高，生存率低。由于缺乏可靠的早期疾病检测方法，识别卵巢癌复发的危险因素很重要。本研究旨在探讨上皮性卵巢癌复发的危险因素。
采用SPSS 10.0统计软件，通过逻辑回归模型分析109例上皮性卵巢癌患者可能与复发相关的因素，包括年龄、病理类型、国际妇产科联盟（FIGO）分期、手术方式、化疗方案、新辅助化疗、术后化疗周期、首次手术情况及残余肿瘤大小。
109例卵巢癌患者中，36例（33%）在手术和化疗联合治疗后复发，无复发生存期的中位数为19个月。109例患者和复发患者的5年生存率分别为62.7%和43.3%。盆腔复发（50.1%）和盆腔外复发（36.1%）的生存率无统计学差异。单因素分析显示，黏液腺癌或FIGO I期患者的复发风险低于其他病理类型或FIGO分期患者（β=-1.565和-1.799，P=0.0120和0.026），而化疗周期超过8个周期的患者复发风险高于化疗周期为1-4个或6-8个周期的患者（β=-3.591和-1.500，P<0.001和=0.038）。多因素分析显示，组织学类型、FIGO分期和术后化疗周期分别独立地对上皮性卵巢癌的复发有显著影响（RR分别为3.473、4.713和6.140，P<0.05）。
组织学类型、FIGO分期和术后化疗周期影响上皮性卵巢癌的复发。由于FIGO分期是复发的显著危险因素，早期诊断应是降低复发的关键。合理的化疗方案对卵巢癌治疗至关重要，但过度化疗对疗效不利。
