Shimizu Dai, Sato Naoki, Sato Toshiharu, Makino Kenichi, Kito Masahiko, Shirasawa Hiromitsu, Kumagai Jin, Terada Yukihiro
Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita, Japan.
J Obstet Gynaecol Res. 2015 Mar;41(3):432-9. doi: 10.1111/jog.12551. Epub 2014 Oct 20.
Adjuvant chemotherapy is generally recommended for early stage epithelial ovarian cancer. However, it remains uncertain which histological subtypes and substages of stage I disease should receive adjuvant chemotherapy. The objective of this study is to determine the impact of chemotherapy among stage I epithelial ovarian cancer.
Of the 267 patients with stage I epithelial ovarian cancer analyzed in this study, 152 patients received adjuvant chemotherapy (AC-positive group) and 115 patients did not (AC-negative group). Survival analysis was retrospectively performed to determine the effectiveness of adjuvant chemotherapy in stage I epithelial ovarian cancer patients.
Recurrence was observed in 14 patients in the AC-negative group and 20 patients in the AC-positive group. There were no statistically significant differences in disease-free survival (DFS) and overall survival between the two groups. In stage IA and IB patients, there was no statistically significant difference in DFS and overall survival based on adjuvant chemotherapy status. However, in patients with intraoperative tumor capsule rupture, the AC-positive group had significantly better DFS than the AC-negative group (P = 0.01). Patients with clear cell carcinoma who received adjuvant chemotherapy had better DFS than patients who did not (P = 0.004).
Adjuvant chemotherapy may not be necessary for patients with stage IA or IB epithelial ovarian cancer, but may be beneficial for clear cell carcinoma patients with intraoperative tumor rupture.
辅助化疗通常推荐用于早期上皮性卵巢癌。然而,对于Ⅰ期疾病的哪些组织学亚型和亚分期应接受辅助化疗仍不确定。本研究的目的是确定化疗对Ⅰ期上皮性卵巢癌的影响。
本研究分析的267例Ⅰ期上皮性卵巢癌患者中,152例接受了辅助化疗(AC阳性组),115例未接受(AC阴性组)。进行回顾性生存分析以确定辅助化疗对Ⅰ期上皮性卵巢癌患者的有效性。
AC阴性组有14例患者复发,AC阳性组有20例患者复发。两组之间的无病生存期(DFS)和总生存期无统计学显著差异。在ⅠA期和ⅠB期患者中,基于辅助化疗状态的DFS和总生存期无统计学显著差异。然而,在术中肿瘤包膜破裂的患者中,AC阳性组的DFS明显优于AC阴性组(P = 0.01)。接受辅助化疗的透明细胞癌患者的DFS优于未接受辅助化疗的患者(P = 0.004)。
ⅠA期或ⅠB期上皮性卵巢癌患者可能无需辅助化疗,但对于术中肿瘤破裂的透明细胞癌患者可能有益。