Ⅱ期-Ⅳ期浆液性卵巢交界性肿瘤的复发模式及辅助化疗的作用。
Patterns of recurrence and role of adjuvant chemotherapy in stage II-IV serous ovarian borderline tumors.
机构信息
Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
出版信息
Gynecol Oncol. 2010 Nov;119(2):270-3. doi: 10.1016/j.ygyno.2010.07.019. Epub 2010 Aug 16.
OBJECTIVE
The objective of this study was to evaluate patterns of recurrence and prognostic factors as well as the role of adjuvant chemotherapy in stage II-IV ovarian SBT.
METHODS
We performed a retrospective review of all patients with advanced-stage SBT treated at our institution from 1979 to 2008. Advanced stage was defined as FIGO stage II-IV. Progression-free survival (PFS) was defined as the time of diagnosis to time of recurrence/death or last follow-up. Kaplan-Meier method was used to report the PFS rate.
RESULTS
A total of 80 stage II-IV patients were identified, of which 15 (19%) were stage II, 63 (79%) were stage III, and 2 (2.5%) were stage IV. The site of metastasis was pelvis in 15 patients (19%), omentum in 29 patients (36%), isolated lymph nodes in 2 patients (2.5%), lung in 1 patient (1%), axilla in 1 patient (1%), and multiple sites in 32 patients (40%). With a median follow-up of 4.8 years, 17 patients (21%) developed recurrent disease. Only patients with metastasis to the omentum or multiple sites developed recurrent disease. Of the 65 stage III/IV patients, 17 patients (26%) received adjuvant chemotherapy following diagnosis. The 3-year progression-free survival (PFS) was 89.9% (95% CI, 77.3-95.7) for patients who did not receive adjuvant chemotherapy compared with 70.6% (95% CI, 43.1-86.6) for patients who received adjuvant chemotherapy.
CONCLUSIONS
While advanced-stage ovarian SBT generally has a good prognosis, nearly 21% of patients develop recurrent disease with intermediate follow-up. It is unclear from these data if adjuvant chemotherapy influenced PFS.
目的
本研究旨在评估复发性疾病的模式和预后因素，以及辅助化疗在 II-IV 期卵巢 SBT 中的作用。
方法
我们对 1979 年至 2008 年在我院治疗的所有晚期 SBT 患者进行了回顾性分析。晚期阶段定义为 FIGO 分期 II-IV 期。无进展生存期（PFS）定义为诊断时间至复发/死亡或最后一次随访时间。Kaplan-Meier 法用于报告 PFS 率。
结果
共确定了 80 例 II-IV 期患者，其中 15 例（19%）为 II 期，63 例（79%）为 III 期，2 例（2.5%）为 IV 期。转移部位为骨盆 15 例（19%），大网膜 29 例（36%），孤立淋巴结 2 例（2.5%），肺 1 例（1%），腋窝 1 例（1%），多个部位 32 例（40%）。中位随访 4.8 年后，17 例（21%）患者出现疾病复发。只有大网膜或多个部位转移的患者出现了复发。在 65 例 III/IV 期患者中，17 例（26%）患者在诊断后接受了辅助化疗。未接受辅助化疗的患者 3 年无进展生存率（PFS）为 89.9%（95%CI，77.3-95.7），而接受辅助化疗的患者为 70.6%（95%CI，43.1-86.6）。
结论
尽管晚期卵巢 SBT 通常预后良好，但在中期随访中，近 21%的患者出现复发性疾病。从这些数据中尚不清楚辅助化疗是否影响了 PFS。
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