Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Japan.
Gynecol Oncol. 2011 Dec;123(3):474-8. doi: 10.1016/j.ygyno.2011.08.036. Epub 2011 Sep 28.
We analyzed a large number of stage I clear cell carcinoma of the ovary (CCC) patients to estimate the survival impact of the capsule status in stage I CCC patients, particularly in comparison with non-CCC patients.
Clinicopathologic data on 564 patients with stage I epithelial ovarian cancer (EOC) collected under the central pathological review system were subjected to uni- and multivariable analyses to evaluate the disease-free survival (DFS) and overall survival (OS).
There was no significant difference in both the OS and DFS of CCC patients between IA and IC(ir) (intraoperative capsule rupture) {IA vs. IC(ir); OS: P=0.1402, DFS: P=0.2701}. In contrast, CCC patients at IC(non-ir) {IC excluding for IC(ir), such as preoperative capsule rupture, positive ascites/washing, and surface involvement} showed a poorer OS and DFS than those at IC(ir), or those at the corresponding stage in non-CCC. In multivariable analysis, the capsule status was an independent prognostic factor of a poor OS and DFS {OS: HR, 2.832; 95% CI 1.156-6.938; P=0.023; DFS: HR, 4.327; 95% CI, 1.937-9.667; P=0.0004)} {In contrast, non-CCC: N.S. (OS/DFS)}. Furthermore, in CCC patients, intraperitoneal recurrences were more frequently observed in IC(non-ir) CCC than IA or IC(ir) CCC (P=0.0083) {In contrast, non-CCC: N.S.}.
This study suggests that CCC patients other than those with intraoperative capsule rupture show a considerable risk for mortality despite adjuvant chemotherapy.
我们分析了大量的Ⅰ期透明细胞癌（CCC）患者，以评估Ⅰ期 CCC 患者的囊膜状态对生存的影响，尤其是与非 CCC 患者的比较。
采用中央病理审查系统收集了 564 例Ⅰ期上皮性卵巢癌（EOC）患者的临床病理资料，进行单因素和多因素分析，以评估无疾病生存期（DFS）和总生存期（OS）。
IA 期和 IC（ir）期（术中囊膜破裂）CCC 患者的 OS 和 DFS 无显著差异{IA 与 IC（ir）；OS：P=0.1402，DFS：P=0.2701}。相比之下，IC（non-ir）期（不包括 IC（ir），如术前囊膜破裂、阳性腹水/冲洗液和表面侵犯）的 CCC 患者的 OS 和 DFS 比 IC（ir）期或非 CCC 相应分期的患者更差。多因素分析显示，囊膜状态是 OS 和 DFS 不良的独立预后因素{OS：HR，2.832；95%CI 1.156-6.938；P=0.023；DFS：HR，4.327；95%CI，1.937-9.667；P=0.0004)} {相比之下，非 CCC：无统计学意义（OS/DFS）}。此外，在 CCC 患者中，IC（non-ir）期 CCC 较 IA 或 IC（ir）期 CCC 更常发生腹腔内复发（P=0.0083）{相比之下，非 CCC：无统计学意义}。
本研究表明，除术中囊膜破裂的 CCC 患者外，其他 CCC 患者尽管接受了辅助化疗，仍存在较高的死亡风险。
