Ye Shuang, Yang Jiaxin, You Yan, Cao Dongyan, Bai Huimin, Lang Jinghe, Chen Jie, Shen Keng
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Fertil Steril. 2014 Dec;102(6):1656-62. doi: 10.1016/j.fertnstert.2014.08.008. Epub 2014 Sep 23.
To analyze and compare the clinicopathological features and prognosis of ovarian clear cell carcinoma (CCC) with or without endometriosis in Chinese patients.
Comparative study based on a retrospective review of medical charts.
A general university hospital.
PATIENT(S): Two hundred ten patients diagnosed and treated with ovarian CCC between 2000 and 2012.
INTERVENTION(S): Patients were divided into two groups depending on coexisting endometriosis. A comparison of clinicopathological characteristics was performed. The Kaplan-Meier model and Cox regression were employed in survival analysis.
MAIN OUTCOME MEASURE(S): Clinicopathological parameters and survival outcomes.
RESULT(S): Of 210 patients, 79 (37.6%) were confirmed to have concurrent endometriosis. Patients with endometriosis were 8 years younger than those without. They were more likely to present at early stage (78.5%) with resectable tumors in primary surgery (with optimal cytoreduction rate at 89.9%) and platinum-sensitive disease (51.7%). Median overall survival for patients with endometriosis was 115 months, an increase of 52 months when compared with 63 months for patients without endometriosis. The 5-year survival rate in patients with endometriosis was 70.2%, while it was 52.6% for those without. Univariate and multivariate analysis showed that coexisting endometriosis was not an independent predictor of survival outcome. Tumor stage and optimal debulking were the independent prognostic factors for both overall survival and progression-free survival.
CONCLUSION(S): Patients with ovarian CCC and coexisting endometriosis had distinct clinicopathological features and better survival outcome. However, endometriosis per se did not confer improved survival.
分析和比较中国患者中伴有或不伴有子宫内膜异位症的卵巢透明细胞癌（CCC）的临床病理特征及预后。
基于病历回顾的对比研究。
一所综合性大学医院。
2000年至2012年间诊断并接受治疗的210例卵巢CCC患者。
根据是否存在并存的子宫内膜异位症将患者分为两组。对临床病理特征进行比较。生存分析采用Kaplan-Meier模型和Cox回归。
临床病理参数和生存结果。
210例患者中，79例（37.6%）被证实同时患有子宫内膜异位症。患有子宫内膜异位症的患者比未患该病的患者年轻8岁。她们更有可能在早期就诊（78.5%），原发手术中肿瘤可切除（最佳细胞减灭率为89.9%）且对铂敏感（51.7%）。患有子宫内膜异位症患者的中位总生存期为115个月，与未患该病患者的63个月相比增加了52个月。患有子宫内膜异位症患者的5年生存率为70.2%，而未患该病患者为52.6%。单因素和多因素分析表明，并存的子宫内膜异位症不是生存结果的独立预测因素。肿瘤分期和最佳减瘤是总生存期和无进展生存期的独立预后因素。
患有卵巢CCC且并存子宫内膜异位症的患者具有独特的临床病理特征和更好的生存结果。然而，子宫内膜异位症本身并未带来生存率的提高。
