Lu Chien-Hsing, Chen I-Hui, Chen Yi-Jen, Wang Kung-Liahng, Qiu Jian-Tai Timothy, Lin Hao, Lin Wu-Chou, Liou Wen-Shiung, Huang Yu-Fang, Lin Yue-Shan, Tee Yi-Torng, Hung Yao-Ching
*Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung; †Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei; ‡Obstetrics and Gynecology Department, National Taiwan University Hospital, Hsin-Chu branch, Hsin-Chu; §Department of Obstetrics and Gynecology, Taipei Veterans General Hospital; ∥Department of Obstetrics and Gynecology, Mackay Memorial Hospital; ¶Department of Nursing, Mackay Medicine, Nursing and Management College; #Department of Obstetrics and Gynecology, Taipei Medical University, Taipei; **Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital; ††Chang Gung University College of Medicine, Taoyuan; ‡‡Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung; §§Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung; ∥∥Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung; ¶¶Department of Obstetrics and Gynecology, National Cheng Kung University and Hospital; ##Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan; ***Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung; and †††College of Medicine, China Medical University, Taichung, Taiwan.
Int J Gynecol Cancer. 2014 Mar;24(3):506-12. doi: 10.1097/IGC.0000000000000083.
This study aimed to determine the clinical prognostic factors involved in carcinosarcoma of the ovary, fallopian tube, and peritoneum.
This retrospective study was undertaken by the Taiwanese Gynecologic Oncology Group. The retrieved clinical data included demographic characteristics, medical disease, tumor status, extent of surgery, and adjuvant chemotherapy.
In total, 63 patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum were identified. Sixty-one patients with complete data were enrolled for further data analysis. The mean follow-up period was 1.0 year, and the mean overall survival was 15.4 months. By log-rank tests, age, menopausal status, parity, hypertension, diabetes, primary tumor size, para-aortic lymph node metastasis, pretreatment CA-125, preceding diagnostic surgery, hysterectomy, lymphadenectomy, other surgeries, and paclitaxel use were not predictive of overall survival.Omentectomy, no gross residual implants after surgery, platinum treatment, and no pelvic lymph node metastasis had a trend toward better survival. Early diagnosis at stage I and cisplatin/ifosfamide regimen were significant associated with a better overall survival in log-rank and simple Cox regression tests. Bilateral ovarian tumors and metastatic tumors larger than 2 cm were significantly associated with a poorer overall survival.
Early diagnosis at stage I, unilateral ovarian tumor, metastatic tumors less than 2 cm, and cisplatin/ifosfamide regimen were predictive of a better survival.Omentectomy and complete debulking surgery also showed a trend toward better survival. Thus, these treatment strategies should be applied in patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum.
本研究旨在确定卵巢、输卵管和腹膜癌肉瘤的临床预后因素。
本回顾性研究由台湾妇科肿瘤学组开展。检索到的临床数据包括人口统计学特征、内科疾病、肿瘤状态、手术范围和辅助化疗。
共确定63例卵巢、输卵管和腹膜癌肉瘤患者。61例有完整数据的患者纳入进一步数据分析。平均随访期为1.0年，平均总生存期为15.4个月。通过对数秩检验，年龄、绝经状态、产次、高血压、糖尿病、原发肿瘤大小、腹主动脉旁淋巴结转移、治疗前CA-125、诊断性手术、子宫切除术、淋巴结清扫术、其他手术和使用紫杉醇不能预测总生存期。大网膜切除术、术后无肉眼可见残留植入物、铂类治疗和无盆腔淋巴结转移有生存更好的趋势。在对数秩检验和简单Cox回归检验中，Ⅰ期早期诊断和顺铂/异环磷酰胺方案与更好的总生存期显著相关。双侧卵巢肿瘤和大于2 cm的转移瘤与较差的总生存期显著相关。
Ⅰ期早期诊断、单侧卵巢肿瘤、小于2 cm的转移瘤和顺铂/异环磷酰胺方案可预测更好的生存期。大网膜切除术和完全减瘤手术也显示出生存更好的趋势。因此，这些治疗策略应应用于卵巢、输卵管和腹膜癌肉瘤患者。
