Chan John K, Cheung Michael K, Husain Amreen, Teng Nelson N, West Dee, Whittemore Alice S, Berek Jonathan S, Osann Kathryn
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, California 94305, USA.
Obstet Gynecol. 2006 Sep;108(3 Pt 1):521-8. doi: 10.1097/01.AOG.0000231680.58221.a7.
To estimate the change in survival rates of women with ovarian cancer during the past 14 years.
Women diagnosed with epithelial, germ cell, sarcomas, and sex-cord stromal ovarian tumors were identified from the Surveillance Epidemiology and End Results Database. Demographic and clinicopathologic factors, and survival information were extracted and tested using chi 2 and Kaplan-Meier and Cox regression analyses.
A total of 30,246 women were diagnosed with ovarian cancer, including 26,753 non-clear cell epithelial, 1,411 clear cell, 818 sarcoma, 778 germ cell, and 486 sex-cord stromal tumors. The 5-year disease-specific survival rate across 1988-1992 and 1993-1997 improved from 45.4% to 48.6% (P < .001). The corresponding estimates show increases for non-clear cell epithelial carcinoma from 42.5% to 45.8% (P < .001), and for sarcomas from 33.5% to 38.8% (P = .07). However, improvements were not observed in those with clear cell, 64.3% to 63.9% (P = .82), and sex-cord stromal, 89.7% to 85.7% (P = .18), tumors of the ovary. In multivariable analyses, younger age, early stage, favorable histologic cell types, low-grade tumors, standard surgery, and recent time interval from 1993-1997 were independent prognostic factors for improved survival.
In this large population-based study, there has been some improvement in the overall survival of women with ovarian cancers during a 14-year period. However, new treatment strategies are warranted for those with epithelial cancer and sarcomas of the ovary, given their overall poor prognosis. These results from our updated analyses might help to counsel women diagnosed with ovarian cancers.
评估过去14年中卵巢癌女性患者生存率的变化。
从监测、流行病学和最终结果数据库中识别出被诊断为上皮性、生殖细胞、肉瘤和性索间质卵巢肿瘤的女性患者。提取人口统计学和临床病理因素以及生存信息，并使用卡方检验、Kaplan-Meier法和Cox回归分析进行检验。
共有30246名女性被诊断为卵巢癌，包括26753例非透明细胞上皮性肿瘤、1411例透明细胞肿瘤、818例肉瘤、778例生殖细胞肿瘤和486例性索间质肿瘤。1988 - 1992年和1993 - 1997年期间，5年疾病特异性生存率从45.4%提高到48.6%（P <.001）。相应的评估显示，非透明细胞上皮癌从42.5%提高到45.8%（P <.001），肉瘤从33.5%提高到38.8%（P =.07）。然而，透明细胞肿瘤患者的生存率从64.3%降至63.9%（P =.82），卵巢性索间质肿瘤患者的生存率从89.7%降至85.7%（P =.18），未观察到改善。在多变量分析中，年龄较小、分期较早、组织学细胞类型良好、肿瘤分级低、标准手术以及1993 - 1997年的较近时间间隔是生存率提高的独立预后因素。
在这项基于人群的大型研究中，14年间卵巢癌女性患者的总体生存率有一定提高。然而，鉴于卵巢上皮癌和肉瘤患者的总体预后较差，需要新的治疗策略。我们更新分析的这些结果可能有助于为被诊断为卵巢癌的女性提供咨询。
