Storey Dawn J, Rush Robert, Stewart Moira, Rye Tzyvia, Al-Nafussi Awatif, Williams Alistair R, Smyth John F, Gabra Hani
Department of Medical Oncology, Edinburgh Cancer Center, Western General Hospital Campus, Edinburgh, United Kingdom.
Cancer. 2008 May 15;112(10):2211-20. doi: 10.1002/cncr.23438.
Clinicopathological features and outcome of women with endometrioid and serous ovarian adenocarcinoma were compared.
Between 1984 and 2004, baseline and follow-up data were prospectively recorded on 1545 patients with ovarian cancer. Of these, 270 had pure endometrioid tumors; 659 had pure serous adenocarcinoma of the ovary. Response to platinum-based chemotherapy (PBC) overall survival, stage-for-stage median progression-free survival (PFS), and cause-specific median survival were compared. Independent predictors of survival were examined by using multivariate analyses.
Median age of diagnosis for patients with endometrioid tumors was younger than those with serous adenocarcinoma of the ovary (60 years vs 62 years; P = .013). They presented more often with early disease (stage I and II; 50% vs 17%; P < .001), had less ascites, and had better performance status both overall and for stage II and III disease. More endometrioid tumors were optimally debulked overall (71% vs 45%; P < .001), but there was no difference according to stage. Objective and CA125 PBC response rates were not significantly different, but median PFS was better for patients with endometrioid tumors (24 months vs 13 months; P < .0001) as was overall median survival (48 months vs 22 months; P < .0001). This relation remained for stage II and III disease and for moderately and poorly differentiated tumors. Patients with concurrent endometrioid ovarian and endometrial malignancies had a survival advantage compared with those with ovarian malignancies alone. Independent predictors of survival after PBC were histological type, debulking status, and disease stage.
Despite similar PBC response rates, endometrioid histology is associated with better survival compared with serous adenocarcinoma of the ovary, even with stage III or poorly differentiated tumors.
比较子宫内膜样和浆液性卵巢腺癌女性患者的临床病理特征及预后。
1984年至2004年间，前瞻性记录了1545例卵巢癌患者的基线和随访数据。其中，270例患有纯子宫内膜样肿瘤；659例患有纯浆液性卵巢腺癌。比较了铂类化疗（PBC）的反应、总体生存率、逐期无进展生存期（PFS）中位数以及特定病因的生存期中位数。通过多因素分析检验生存的独立预测因素。
子宫内膜样肿瘤患者的诊断中位年龄低于浆液性卵巢腺癌患者（60岁对62岁；P = 0.013）。她们更多表现为早期疾病（I期和II期；50%对17%；P < 0.001），腹水较少，总体以及II期和III期疾病的体能状态更好。总体上更多的子宫内膜样肿瘤能达到最佳减瘤效果（71%对45%；P < 0.001），但按分期无差异。客观缓解率和CA125的PBC反应率无显著差异，但子宫内膜样肿瘤患者的PFS中位数更好（24个月对13个月；P < 0.0001），总体生存期中位数也是如此（48个月对22个月；P < 0.0001）。这种关系在II期和III期疾病以及中低分化肿瘤中依然存在。同时患有子宫内膜样卵巢和子宫内膜恶性肿瘤的患者与仅患有卵巢恶性肿瘤的患者相比具有生存优势。PBC后生存的独立预测因素是组织学类型、减瘤状态和疾病分期。
尽管PBC反应率相似，但与浆液性卵巢腺癌相比，子宫内膜样组织学类型与更好的生存率相关，即使是III期或低分化肿瘤。
