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晚期卵巢癌患者总生存的预后因素

Prognostic factors for overall survival in patients with advanced ovarian carcinoma.

作者信息

Lund B, Williamson P

机构信息

Department of Oncology, Finsen Institute, Rigshospitalet, Copenhagen, Denmark.

出版信息

Ann Oncol. 1991 Apr;2(4):281-7. doi: 10.1093/oxfordjournals.annonc.a057937.

Abstract

Twenty-one pretreatment variables were investigated for prognostic influence on survival in 301 previously untreated patients with ovarian carcinoma, stage IIB-IV. Patients were randomized to sequential combination chemotherapy: cyclophosphamide, doxorubicin, 5-fluorouracil, followed by cisplatin and hexamethylmelamine, or to the 3-drug combination alternating with the 2-drug combination every other month. Median overall survivals were 25 and 22 months, respectively, P greater than 0.4. Based on the results from a Cox multivariate stepwise analysis a subset of independent significant prognostic factors was found to include: residual tumor size, performance status, alkaline phosphatase, number of metastases, histological differentiation grade and type. A prognostic index was calculated for each patient and three prognostic categories of patients were determined. The 3-yr survival rates for patients with low-, intermediate-, and high-risk scores were 62, 31, and 7%, respectively. Multivariate analysis thus contributes further information about the disease, and a knowledge of the distribution of such factors across different trials is important when comparing treatment outcome.

摘要

对301例未经治疗的IIB-IV期卵巢癌患者的21个预处理变量进行了研究,以探讨其对生存的预后影响。患者被随机分配接受序贯联合化疗:环磷酰胺、阿霉素、5-氟尿嘧啶,随后是顺铂和六甲蜜胺,或接受3药联合方案与2药联合方案每隔1个月交替使用。中位总生存期分别为25个月和22个月,P大于0.4。基于Cox多变量逐步分析的结果,发现一组独立的显著预后因素包括:残留肿瘤大小、体能状态、碱性磷酸酶、转移灶数量、组织学分化程度和类型。为每位患者计算了一个预后指数,并确定了三类预后患者。低、中、高风险评分患者的3年生存率分别为62%、31%和7%。因此,多变量分析为该疾病提供了更多信息,在比较治疗结果时,了解这些因素在不同试验中的分布情况很重要。

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