Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Gynecol Oncol. 2012 May;125(2):376-80. doi: 10.1016/j.ygyno.2012.02.016. Epub 2012 Feb 21.
The purpose of this study is to analyze and compare the demographics, treatment, recurrence, and survival rates in patients with uterine clear cell carcinoma (UCCC) and ovarian clear cell carcinoma (OCCC).
A retrospective review of the Cancer Registry database was performed. All patients with UCCC and OCCC who underwent surgical staging at the two participating institutions, between January, 1995 and December, 2007, were identified. Categorical variables were evaluated by Chi square test. Survival estimates were plotted utilizing the Kaplan-Meier method.
Analysis of 41 women with UCCC and 121 with OCCC was performed. In patients with OCCC, 48.4% had localized disease, 18.9% had regional spread, 31.1% had distant metastasis, and in 1.6% spread is unknown; compared to UCCC, 41.5% had localized disease, 12.2% regional spread, and 46.3% distant metastasis (p=0.2). The median progression free survival was 31.4 months in women with UCCC, compared to 145 months in patients with OCCC (p=0.04). UCCC women had a median overall survival of 39.5 months, compared to 155.8 months in patients with OCCC (p=0.002). In the multivariate Cox regression model, age>55 years old, tumor extension, optimal cytoreduction, and platinum-based chemotherapy were identified as independent predictors of overall survival. UCCC vs. OCCC was not associated with decreased overall survival in multivariate analysis.
OCCC and UCCC have the same rate of localized disease, regional spread and distant metastasis. After controlling for age, tumor extension, optimal cytoreduction, and platinum based chemotherapy, UCCC was not associated with decreased overall survival compared to OCCC.
本研究旨在分析和比较子宫透明细胞癌（UCCC）和卵巢透明细胞癌（OCCC）患者的人口统计学、治疗方法、复发率和生存率。
对癌症登记数据库进行回顾性分析。在两个参与机构，1995 年 1 月至 2007 年 12 月期间，对接受手术分期的所有 UCCC 和 OCCC 患者进行了识别。采用卡方检验评估分类变量。采用 Kaplan-Meier 方法绘制生存估计图。
对 41 例 UCCC 患者和 121 例 OCCC 患者进行了分析。在 OCCC 患者中，48.4%为局限性疾病，18.9%为区域性播散，31.1%为远处转移，1.6%为未知播散；与 UCCC 相比，41.5%为局限性疾病，12.2%为区域性播散，46.3%为远处转移（p=0.2）。UCCC 患者的无进展生存中位数为 31.4 个月，而 OCCC 患者为 145 个月（p=0.04）。UCCC 患者的总生存中位数为 39.5 个月，而 OCCC 患者为 155.8 个月（p=0.002）。在多变量 Cox 回归模型中，年龄>55 岁、肿瘤扩展、最佳减瘤术和铂类化疗被确定为总生存的独立预测因素。多变量分析中，UCCC 与 OCCC 与总生存降低无关。
OCCC 和 UCCC 的局限性疾病、区域性播散和远处转移发生率相同。在控制年龄、肿瘤扩展、最佳减瘤术和铂类化疗后，UCCC 与 OCCC 相比，总生存率无降低。
