Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
Gynecol Oncol. 2013 Sep;130(3):493-8. doi: 10.1016/j.ygyno.2013.05.040. Epub 2013 Jun 6.
To quantify the impact of complete cytoreduction to no gross residual disease on overall survival among patients with advanced-stage ovarian cancer treated during the platinum-taxane era.
PubMed and Cochrane Library databases were searched for all articles on primary cytoreductive surgery for advanced-stage ovarian cancer published from 1/1996 to 7/2011. A total of 18 relevant studies (13,257 patients) were identified for analysis. Simple and multiple linear regression analyses, with weighted correlation calculations, were used to assess the effect on median survival time of clinical and treatment-related factors.
The mean weighted median overall survival time for all cohorts was 44.4 months (range, 27.6-66.9 months). Simple linear regression analysis revealed that residual disease, stage IV disease, and use of intraperitoneal chemotherapy were significantly associated with median survival time. After controlling for other factors on multiple linear regression analysis, each 10% increase in the proportion of patients undergoing complete cytoreduction to no gross residual disease was associated with a significant and independent 2.3-month increase (95%CI = 0.6-4.0, p = 0.011) in cohort median survival compared to a 1.8-month increase (95%CI = 0.6-3.0, p = 0.004) in cohort median survival for optimal cytoreduction (residual disease≤1cm). Each 10% increase in the proportion of patients receiving intraperitoneal chemotherapy was associated with a significant and independent 3.9-month increase (95%CI = 1.1-6.8, p=0.008) in median cohort survival time.
For advanced-stage ovarian cancer treated during the platinum-taxane era, the proportions of patients left with no gross residual disease and receiving intraperitoneal chemotherapy are independently significant factors associated with the most favorable cohort survival time.
定量分析在铂类药物联合紫杉烷类药物时代接受治疗的晚期卵巢癌患者行满意肿瘤细胞减灭术至无肉眼残留病灶对总生存期的影响。
检索 1996 年 1 月至 2011 年 7 月发表的关于晚期卵巢癌初次细胞减灭术的所有文献，检索数据库包括 PubMed 和 Cochrane Library。共纳入 18 项相关研究（共 13257 例患者）进行分析。采用简单和多元线性回归分析，以及加权相关计算，评估临床和治疗相关因素对中位生存时间的影响。
所有队列的平均加权中位总生存时间为 44.4 个月（范围，27.6-66.9 个月）。简单线性回归分析显示，残留病灶、IV 期疾病和腹腔内化疗的使用与中位生存时间显著相关。多元线性回归分析控制其他因素后，行满意肿瘤细胞减灭术至无肉眼残留病灶的患者比例每增加 10%，与队列中位生存时间显著增加 2.3 个月（95%CI=0.6-4.0，p=0.011）相关，与最佳肿瘤细胞减灭术（残留病灶≤1cm）时队列中位生存时间增加 1.8 个月（95%CI=0.6-3.0，p=0.004）相比，差异有统计学意义。接受腹腔内化疗的患者比例每增加 10%，与队列中位生存时间显著增加 3.9 个月（95%CI=1.1-6.8，p=0.008）相关。
在铂类药物联合紫杉烷类药物时代治疗的晚期卵巢癌患者，无肉眼残留病灶和接受腹腔内化疗的患者比例是与队列生存时间最相关的独立重要因素。
