Teramukai Satoshi, Ochiai Kazunori, Tada Harue, Fukushima Masanori
Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan.
J Clin Oncol. 2007 Aug 1;25(22):3302-6. doi: 10.1200/JCO.2007.11.0114.
The purpose of this study was to construct a simple and powerful prognostic index (PI) of epithelial ovarian cancer, the PIEPOC.
In a retrospective review, data from 768 women with stage III or IV epithelial ovarian cancer from 24 institutions in Japan were evaluated for clinical features predictive of overall survival. A PI and risk groups to predict overall survival after initial surgery were developed using the proportional hazards regression model.
Of six factors, the four prognostic factors that remained independently significant in the analysis of a training sample (538 randomly selected patients) were age, performance status (PS), histologic cell type, and residual tumor size. From the regression function, we derived a PI = 1 (if age 70 and above) + 1 (if PS 1 or 2) + 2 (if PS 3 or 4) + 1 (if mucinous or clear-cell) + 2 (if residual size 0.1 cm and above). Patients were classified into three risk groups (PIEPOC): low risk (PI 0-2), intermediate risk (PI 3), and high risk (PI 4-6). The PIEPOC was equally predictive in a validation sample (n = 230), identifying three groups (5-year survival: 0.67 in low, 0.43 in intermediate, 0.17 in high risk).
Our proposed PI, the PIEPOC, was predictive in our patient population and may have utility in clinical practice. Prospective studies would be needed to confirm the prognostic predictive ability of the PIEPOC for patients with advanced epithelial ovarian cancer.
本研究旨在构建一种简单且强大的上皮性卵巢癌预后指数（PI），即PIEPOC。
在一项回顾性研究中，对来自日本24家机构的768例III期或IV期上皮性卵巢癌女性患者的数据进行评估，以确定预测总生存期的临床特征。使用比例风险回归模型建立预测初始手术后总生存期的PI和风险组。
在六个因素中，在训练样本（随机选择的538例患者）分析中仍具有独立显著意义的四个预后因素为年龄、体能状态（PS）、组织学细胞类型和残留肿瘤大小。根据回归函数，我们得出PI = 1（如果年龄70岁及以上） + 1（如果PS为1或2） + 2（如果PS为3或4） + 1（如果是黏液性或透明细胞性） + 2（如果残留大小0.1 cm及以上）。患者被分为三个风险组（PIEPOC）：低风险（PI 0 - 2）、中风险（PI 3）和高风险（PI 4 - 6）。PIEPOC在验证样本（n = 230）中具有同等的预测能力，识别出三组（5年生存率：低风险组为0.67，中风险组为0.43，高风险组为0.17）。
我们提出的PI，即PIEPOC，在我们的患者群体中具有预测性，可能在临床实践中有用。需要进行前瞻性研究以证实PIEPOC对晚期上皮性卵巢癌患者的预后预测能力。
