Xu Xia, Chen Xiaoxiang, Dai Zhiqin, Deng Fei, Qu Junwei, Ni Jing
Department of Gynecologic Oncology, Jiangsu Cancer Hospital, Nanjing, Jiangsu 210009, PR China.
J Exp Clin Cancer Res. 2013 Sep 2;32(1):61. doi: 10.1186/1756-9966-32-61.
There is no consensus regarding the secondary cytoreduction surgery (CRS) in recurrent ovarian cancer patients. The present study aims to determine the value of secondary CRS and the eligible subgroup for this procedure.
96 platinum-sensitive recurrent ovarian cancer patients were recruited from Jiangsu Institute of Cancer Research between 1992 and 2011. Follow-up was conducted based on the surveillance protocol of MD Anderson Cancer Center. Cox proportional hazards model and log-rank test were used to assess the associations between the survival durations and covariates. Logistic regression analysis was used to explore optimal secondary CRS related factors.
Optimal secondary CRS was associated with time to progression (TTP) and overall survival (OS) in patients (p < 0.01 both). Optimal secondary CRS and asymptomatic recurrent were similarly associated with longer OS (median: 79.2 vs. 53.9 and 76.1 vs. 56.0 months with p = 0.02 and p = 0.04, respectively) and TTP (median: 13.9 vs. 10.5 and 19.3 vs. 9.0 months with p = 0.02 and p = 0.03, respectively) than counterparts. Optimal initial CRS (p = 0.01), asymptomatic recurrent (p = 0.02) and longer progression-free survival duration (p = 0.02) were the independent indicators of optimal secondary CRS.
Optimal secondary CRS had survival benefit for platinum-sensitive epithelial ovarian cancer. Asymptomatic recurrent was one of the recruited factors for this procedure.
对于复发性卵巢癌患者的二次肿瘤细胞减灭术(CRS)尚无共识。本研究旨在确定二次CRS的价值以及该手术的合适亚组。
1992年至2011年间从江苏省肿瘤研究所招募了96例铂敏感复发性卵巢癌患者。根据MD安德森癌症中心的监测方案进行随访。采用Cox比例风险模型和对数秩检验评估生存时间与协变量之间的关联。采用逻辑回归分析探索最佳二次CRS相关因素。
最佳二次CRS与患者的疾病进展时间(TTP)和总生存期(OS)相关(两者p均<0.01)。最佳二次CRS和无症状复发与较长的OS(中位数:79.2对53.9个月和76.1对56.0个月,p分别为0.02和0.04)和TTP(中位数:13.9对10.5个月和19.3对9.0个月,p分别为0.02和0.03)相关,优于相应情况。最佳初次CRS(p = 0.01)、无症状复发(p = 0.02)和较长的无进展生存期(p = 0.02)是最佳二次CRS的独立指标。
最佳二次CRS对铂敏感的上皮性卵巢癌有生存益处。无症状复发是该手术的入选因素之一。