Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Gynecol Oncol. 2011 Aug;122(2):334-8. doi: 10.1016/j.ygyno.2011.04.016. Epub 2011 May 14.
The purpose of this study was to clarify the clinical outcome of patients with stage IA mucinous epithelial ovarian cancer (mEOC) treated with fertility-sparing surgery (FSS).
After a central pathological review and search of the medical records from multiple institutions, a total of 148 stage I mEOC patients were retrospectively evaluated in the current study. All mEOC patients were divided into three groups: group A (FSS; age, 40≥); groups B and C {radical surgery; age, 40≥ (B); 40< (C)}. Survival analysis was performed among these three groups using Kaplan-Meier methods.
The median follow-up time of all mEOC patients was 71.6 (4.8-448.3) months. Among the 41 patients in group A, 27 patients (65.9%) had IA disease, and 14 (34.1%) had IC disease. Five-year overall survival (OS) and disease-free survival (DFS) rates of patients in the groups were as follows: group A, 97.3% (OS)/90.5% (DFS); group B, 94.4% (OS)/94.4% (DFS); group C; 97.3% (OS)/89.3% (DFS). Collectively, there was no significant difference in OS or DFS among these groups even though they were stratified to each substage (IA/IC) (OS, P=0.180; DFS, P=0.445, respectively). Furthermore, in multivariate analyses, the surgical procedure was not an independent prognostic factor for either OS or DFS (OS, HR: 0.340, 95% CI: 0.034-3.775, P=0.352; DFS, HR: 0.660, 95% CI: 0.142-3.070, P=0.596).
Patients with stage I mEOC treated with FSS did not necessarily show a poorer prognosis than those receiving radical surgery.
本研究旨在阐明行保留生育功能手术（FSS）治疗的 IA 期黏液性上皮性卵巢癌（mEOC）患者的临床结局。
经中心病理复查和多家医疗机构病历检索，本研究回顾性评估了 148 例 IA 期 mEOC 患者。所有 mEOC 患者分为三组：A 组（FSS；年龄，40≥）；B 组和 C 组{根治性手术；年龄，40≥（B）；40<（C）}。采用 Kaplan-Meier 法对三组患者进行生存分析。
所有 mEOC 患者的中位随访时间为 71.6（4.8-448.3）个月。A 组 41 例患者中，27 例（65.9%）为 IA 期疾病，14 例（34.1%）为 IC 期疾病。各组患者的 5 年总生存率（OS）和无病生存率（DFS）如下：A 组，97.3%（OS）/90.5%（DFS）；B 组，94.4%（OS）/94.4%（DFS）；C 组；97.3%（OS）/89.3%（DFS）。尽管按每个亚分期（IA/IC）分层，各组之间 OS 或 DFS 均无显著差异（OS，P=0.180；DFS，P=0.445）。此外，多因素分析显示，手术方式不是 OS 或 DFS 的独立预后因素（OS，HR：0.340，95%CI：0.034-3.775，P=0.352；DFS，HR：0.660，95%CI：0.142-3.070，P=0.596）。
行 FSS 治疗的 IA 期 mEOC 患者的预后不一定比行根治性手术的患者差。
