同步性原发性卵巢癌和子宫内膜癌：基于人群的生存评估

Synchronous primary ovarian and endometrial cancers: a population-based assessment of survival.

作者信息

Williams Melony G, Bandera Elisa V, Demissie Kitaw, Rodríguez-Rodríguez Lorna

机构信息

From the Robert Wood Johnson Medical School, Division of Surgical Oncology, New Brunswick, NJ; The Cancer Institute of New Jersey, Population Science Program, New Brunswick, NJ; UMDNJ-School of Public Health, Department of Epidemiology, Piscataway, NJ; The Cancer Institute of New Jersey, Robert Wood Johnson Medical School and Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New Brunswick, NJ.

出版信息

Obstet Gynecol. 2009 Apr;113(4):783-789. doi: 10.1097/AOG.0b013e31819c7bdf.

DOI:10.1097/AOG.0b013e31819c7bdf

PMID:19305320

Abstract

OBJECTIVE

To estimate the occurrence of synchronous epithelial ovarian and endometrial cancers among ovarian cancer patients and to assess survival of women with synchronous cancers.

METHODS

Synchronous ovarian and endometrial cases were identified using data from the Surveillance, Epidemiology, and End Results Program from 1973 to 2005. Multivariable Cox-proportional hazards regression was used to estimate risk of death from ovarian cancer, comparing synchronous ovarian and endometrial cancers with single ovarian cancers and adjusting for demographic, prognostic, and treatment characteristics.

RESULTS

Synchronous cancers represented less than 3% of the 56,986 epithelial ovarian cancer cases, regardless of the time interval between detection of both cancers. Favorable characteristics for synchronous patients included younger age at diagnosis, earlier stage of disease, and better grade of disease. Multivariable adjusted hazard ratios showed a 25% reduction in risk of death from ovarian cancer for synchronous tumors compared with single tumors (hazard ratio 0.75, 95% confidence interval [CI] 0.66-0.85). In stratified analysis by stage, the corresponding hazard ratios for localized and distant stages were 0.63 (95% CI 0.42-0.95) and 0.70 (95% CI 0.60-0.81), respectively.

CONCLUSION

Women with synchronous ovarian and endometrial cancers exhibit favorable survival outcomes as compared with patients with single ovarian cancers, even after adjusting for demographic, prognostic (including stage), and treatment characteristics. The survival advantage associated with having synchronous cancers persisted after analyses were restricted to distant stage.

LEVEL OF EVIDENCE

III.

摘要

目的

评估卵巢癌患者中同时发生上皮性卵巢癌和子宫内膜癌的情况，并评估同时患两种癌症女性的生存率。

方法

利用1973年至2005年监测、流行病学和最终结果计划的数据，确定同时发生的卵巢和子宫内膜病例。采用多变量Cox比例风险回归模型，估计卵巢癌死亡风险，将同时发生的卵巢和子宫内膜癌与单一卵巢癌进行比较，并对人口统计学、预后和治疗特征进行调整。

结果

在56986例上皮性卵巢癌病例中，同时发生的癌症占比不到3%，无论两种癌症检测的时间间隔如何。同时患癌患者的有利特征包括诊断时年龄较轻、疾病分期较早和疾病分级较好。多变量调整后的风险比显示，与单一肿瘤相比，同时发生的肿瘤患者因卵巢癌死亡的风险降低了25%（风险比0.75，95%置信区间[CI]0.66 - 0.85）。在按阶段进行的分层分析中，局部和远处阶段的相应风险比分别为0.63（95%CI 0.42 - 0.95）和0.70（95%CI 0.60 - 0.81）。