输卵管、卵巢、腹膜和子宫浆液性癌患者的生存差异。

Survival differences in women with serous tubal, ovarian, peritoneal, and uterine carcinomas.

机构信息

Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA.

Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA; Division of Gynecologic Oncology, California Pacific & Palo Alto Medical Foundation Sutter Research Institute, Palo Alto, CA.

出版信息

Am J Obstet Gynecol. 2015 Feb;212(2):188.e1-6. doi: 10.1016/j.ajog.2014.08.016. Epub 2014 Aug 18.

DOI:10.1016/j.ajog.2014.08.016

PMID:25149685

Abstract

OBJECTIVE

The fallopian tube has been implicated as the primary origin of pelvic serous cancers. We proposed to determine the survival outcomes of serous tubal, ovarian, peritoneal, and uterine cancer patients.

STUDY DESIGN

Data were obtained from the National Cancer Institute between 2004 and 2009. Kaplan-Meier and Cox proportional hazards models were used for analysis.

RESULTS

Of 12,336 high-grade serous cancer patients, 563 were tubal (TC), 8560 ovarian (OC), 1037 primary peritoneal (PPC), and 2176 uterine cancer (USC). The median ages of these patients were 63 vs 62 vs 67 vs 68 years, respectively. The majority were white (89% vs 88% vs 91% vs 74%). The overall 5 year, disease-specific survival was 37%. The survivals of those with TC, OC, PPC, and USC were 50%, 37%, 26%, and 40% (P < .01). There was no detailed staging on PPC cancers. Adjusted for stage, the survival of those with stage I, II, III, and IV TC were 73%, 62%, 44%, and 22% (P < .01), OC were 83%, 64%, 34%, and 15% (P < .01), and USC were 88%, 72%, 55%, and 17% (P < .01). On multivariate analysis, younger age, white race, earlier stage, and tubal origin were independent predictors for improved survival.

CONCLUSION

In advanced-staged serous cancer patients, tubal cancer patients have better survivals compared with ovarian, peritoneal, and uterine cancer.

摘要

目的

输卵管被认为是盆腔浆液性癌的主要起源。我们旨在确定输卵管癌、卵巢癌、腹膜癌和子宫癌患者的生存结果。

研究设计

数据来自国家癌症研究所 2004 年至 2009 年的资料。采用 Kaplan-Meier 和 Cox 比例风险模型进行分析。

结果

在 12336 例高级别浆液性癌患者中，563 例为输卵管癌（TC），8560 例为卵巢癌（OC），1037 例为原发性腹膜癌（PPC），2176 例为子宫癌（USC）。这些患者的中位年龄分别为 63 岁、62 岁、67 岁和 68 岁。大多数为白人（89%、88%、91%和 74%）。整体 5 年疾病特异性生存率为 37%。TC、OC、PPC 和 USC 的生存率分别为 50%、37%、26%和 40%（P<.01）。对 PPC 癌症没有详细的分期。调整分期后，I 期、II 期、III 期和 IV 期 TC 的生存率分别为 73%、62%、44%和 22%（P<.01），OC 分别为 83%、64%、34%和 15%（P<.01），USC 分别为 88%、72%、55%和 17%（P<.01）。多变量分析显示，年龄较小、白人种族、早期分期和输卵管来源是改善生存的独立预测因素。