Akeson Margaretha, Jakobsen Anne-Marie, Zetterqvist Britt-Marie, Holmberg Erik, Brännström Mats, Horvath György
Department of Oncology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
Int J Gynecol Cancer. 2009 Jan;19(1):116-23. doi: 10.1111/IGC.0b013e3181991b13.
Epithelial ovarian cancer (EOC) is the major gynecologic cancer mortality cause in Sweden. The aim of the present study was to investigate the long-term survival and prognostic factors of a complete population-based 5-year cohort of 682 patients with invasive EOC in western Sweden (population around 1.6 million). Data relating to residual tumor after surgery, FIGO stage, grade, histopathologic subtype, ploidy status, adjuvant chemotherapy (the prepaclitaxel period), and disease state (recurrence and death) were reported to a quality register in a prospectively kept database and were controlled against the Swedish National Cancer Registry for completeness. The median follow-up durations for the prospectively collected data in the Cox analysis and for the survival analysis that was made for all patients were 81 months (range, 52-109 months) and 11.7 years (range, 8.7-14.1 years), respectively. No patient was lost to follow-up. The relative 10-year survival rate was 38.4% (95% confidence interval, 34.5%-42.8%). The median relative survival time was 4.3 years (95% confidence interval, 3.6%-5.2%). In the univariate Cox regression analysis, prognostic significances for age, stage, residual tumor, histopathologic subtype of serous cystadenocarcinoma, grade, CA-125, and ploidy status were seen. In the multivariate analysis, age, stage, residual tumor after surgery, and postoperative CA-125 were of prognostic significance. In conclusion, 4 major prognostic factors were found for EOC in this population-based cohort study that also presents nearly accurate long-term survival owing to the nonselective nature and completeness regarding patients and follow-up of the study.
上皮性卵巢癌（EOC）是瑞典妇科癌症的主要致死原因。本研究的目的是调查瑞典西部一个基于人群的完整5年队列中682例浸润性EOC患者（该地区人口约160万）的长期生存情况及预后因素。有关手术后残留肿瘤、国际妇产科联盟（FIGO）分期、分级、组织病理学亚型、倍体状态、辅助化疗（紫杉醇前时期）以及疾病状态（复发和死亡）的数据被报告至一个前瞻性维护数据库中的质量登记处，并与瑞典国家癌症登记处进行核对以确保完整性。在Cox分析中前瞻性收集的数据以及对所有患者进行的生存分析的中位随访时间分别为81个月（范围52 - 109个月）和11.7年（范围8.7 - 14.1年）。没有患者失访。10年相对生存率为38.4%（95%置信区间，34.5% - 42.8%）。中位相对生存时间为4.3年（95%置信区间，3.6% - 5.2%）。在单变量Cox回归分析中，年龄、分期、残留肿瘤、浆液性囊腺癌的组织病理学亚型、分级、CA - 125和倍体状态具有预后意义。在多变量分析中，年龄、分期、手术后残留肿瘤和术后CA - 125具有预后意义。总之，在这项基于人群的队列研究中发现了EOC的4个主要预后因素，由于该研究在患者和随访方面具有非选择性和完整性，其长期生存情况也近乎准确。
