Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-cho 65, Showa-ku, Nagoya, 466-8550, Japan,
Int J Clin Oncol. 2014 Feb;19(1):121-6. doi: 10.1007/s10147-013-0522-0. Epub 2013 Feb 8.
This study was conducted to assess the long-term clinical outcome for patients with recurrent mucinous epithelial ovarian cancer (RmOC) in comparison with recurrent serous epithelial ovarian cancer (RsOC).
Three hundred and eighty-four patients with recurrent ovarian cancer, including 340 RsOC and 44 RmOC patients, were analyzed in this study. The pathological slides were evaluated under central pathological review. The prognostic significance of clinicopathological factors was evaluated employing both uni- and multivariable analysis.
The 3- and 5-year postrecurrence survival (PRS) rates of patients with RmOC were 17.3, and 6.9 %, respectively. In contrast, those of patients with RsOC were 29.8 and 18.8 %, respectively. The PRS of patients with RmOC was significantly poorer than that of patients with RsOC (PRS: P = 0.0006). Moreover, either in the presence or absence of a residual tumor (RT) at initial surgery, the PRS of patients with RmOC was markedly poorer than that of patients with RsOC [RT (-): P < 0.0001: RT (+): P = 0.0912]. In multivariable analysis, a mucinous histology predicted a significantly poorer PRS (RmOC vs. RsOC: hazard ratio (HR) 2.080, 95 % confidence interval (CI) 1.434-3.016, P = 0.0001). Confining analysis to deceased patients (N = 302), the proportion of RmOC patients who died within 12 months following recurrence was markedly higher than that of RsOC [RmOC 69.2 %, RsOC: 41.1 % (P < 0.0001)].
The clinical outcome after recurrence in patients with RmOC was extremely poor. This confirms that RmOC should be considered a different entity from other epithelial ovarian cancers.
本研究旨在评估复发性黏液性上皮性卵巢癌(RmOC)患者与复发性浆液性上皮性卵巢癌(RsOC)患者的长期临床结局。
本研究分析了 384 例复发性卵巢癌患者,包括 340 例 RsOC 和 44 例 RmOC 患者。病理切片经中心病理复查评估。采用单变量和多变量分析评估临床病理因素的预后意义。
RmOC 患者的 3 年和 5 年复发后生存率(PRS)分别为 17.3%和 6.9%,而 RsOC 患者的 3 年和 5 年 PRS 分别为 29.8%和 18.8%。RmOC 患者的 PRS 明显低于 RsOC 患者(PRS:P=0.0006)。此外,无论初始手术时是否存在残留肿瘤(RT),RmOC 患者的 PRS 均明显低于 RsOC 患者[RT(-):P<0.0001:RT(+):P=0.0912]。多变量分析显示,黏液组织学预示着明显较差的 PRS(RmOC 与 RsOC:风险比(HR)2.080,95%置信区间(CI)1.434-3.016,P=0.0001)。将分析仅限于死亡患者(N=302),复发后 12 个月内 RmOC 患者死亡的比例明显高于 RsOC[RmOC 69.2%,RsOC:41.1%(P<0.0001)]。
RmOC 患者复发后的临床结局极差。这证实了 RmOC 应被视为与其他上皮性卵巢癌不同的实体瘤。