Dept. of Gynecology, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Molecular Unit, Dept. of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Gynecol Oncol. 2015 Feb;136(2):205-11. doi: 10.1016/j.ygyno.2014.12.029. Epub 2014 Dec 27.
To investigate the prognostic significance of dividing epithelial ovarian cancer (EOC) in type I and type II tumors based on pathologic variables.
We used the Danish Gynecologic Cancer Database to identify all patients diagnosed with EOC from 2005 to 2012. Information on histologic type and grade were used to classify tumors as either type I or type II. Death, and several prognostic factors were used in the multivariate Cox regression, and Landmark analysis was used to estimate hazard ratios of all-cause mortality.
Among 2660 patients diagnosed with EOC, 735 were categorized as type I tumors, and 1925 as type II tumors. Patients with type II EOC were more frequently diagnosed in late FIGO stages (stages III-IV) than patients with type I EOC (78.1% vs. 32.1% respectively; P<0.001). Time dependent multivariate Cox analysis, adjusted for known prognostic variables, showed no significant difference in survival within the first two years after diagnosis, however, after 730days of follow-up a significantly increased overall survival for type I tumors was observed (hazard ratio 1.72, 95% confidence interval: 1.28-2.31, P<0.001). Similarly the Landmark analysis for survival confirmed the increased overall survival for type I tumors after two years of follow-up (hazard ratio: 1.85, 95% confidence interval: 1.35-2.54, P<0.001).
Classification of EOC in type I and type II tumors based on pathologic variables was associated with an increased risk of death for type II tumors after two years of follow-up, while no increased risk was seen during the first two years of follow-up.
探讨基于病理变量将上皮性卵巢癌（EOC）分为 I 型和 II 型肿瘤的预后意义。
我们使用丹麦妇科癌症数据库来确定 2005 年至 2012 年间所有诊断为 EOC 的患者。使用组织学类型和分级信息将肿瘤分类为 I 型或 II 型。使用多变量 Cox 回归分析死亡和多个预后因素，使用 landmark 分析估计全因死亡率的危险比。
在 2660 例诊断为 EOC 的患者中，735 例为 I 型肿瘤，1925 例为 II 型肿瘤。与 I 型 EOC 患者相比，II 型 EOC 患者更常被诊断为晚期 FIGO 分期（III-IV 期）（分别为 78.1%和 32.1%；P<0.001）。经过已知预后因素调整的时间依赖性多变量 Cox 分析显示，在诊断后的前两年内，生存率无显著差异，但在 730 天的随访后，I 型肿瘤的总生存率显著提高（危险比 1.72，95%置信区间：1.28-2.31，P<0.001）。同样，生存的 landmark 分析也证实了 I 型肿瘤在两年随访后总生存率的提高（危险比：1.85，95%置信区间：1.35-2.54，P<0.001）。
基于病理变量将 EOC 分为 I 型和 II 型肿瘤与 II 型肿瘤在两年随访后的死亡风险增加相关，而在随访的前两年内未见风险增加。
