Kim Hee Seung, Kim Min A, Lee Maria, Suh Dong Hoon, Kim Kidong, No Jae Hong, Chung Hyun Hoon, Kim Yong Beom, Song Yong Sang
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Ann Surg Oncol. 2015 Aug;22(8):2738-45. doi: 10.1245/s10434-014-4319-9. Epub 2015 Feb 14.
Whether endometriosis affects the prognosis of ovarian clear cell carcinoma (OCCC) remains controversial despite the relationship between OCCC and endometriosis. A two-center cohort study and meta-analysis were performed to investigate the effect of endometriosis on the prognosis of OCCC.
The study reviewed the clinicopathologic data of 109 patients with OCCC arising (n = 47) or not arising (n = 62) in endometriosis between 1997 and 2012 at two tertiary medical centers. Tumor response and survival were compared between the two groups. For further evaluation, PubMed, EmBase, and the Cochrane Library were searched, and a meta-analysis was conducted using 10 cohort studies published from March 1996 to May 2014, including the current cohort study.
Complete response did not differ between the patients with OCCC arising in endometriosis and those without endometriosis (77.5 vs. 87.3 %; P = 0.444). Early-stage disease and optimal debulking surgery were the only independent factors that reduced the risk of noncomplete response (adjusted odds ratios 0.203 and 0.038; 95 % confidence intervals [CIs] 0.045-0.920 and 0.006-0.226, respectively). Progression-free survival (PFS) and overall survival (OS) did not differ between the two groups. Early-stage disease and optimal debulking surgery were the only favorable factors that improved PFS (adjusted hazard ratios [HRs] 0.216 and 0.332; 95 % CIs 0.099-0.469 and 0.150-0.732, respectively) and OS (adjusted HRs 0.099 and 0.339; 95 % CIs 0.039-0.252 and 0.141-0.815, respectively). Furthermore, crude and subgroup meta-analyses showed no effect of endometriosis on PFS or OS in OCCC patients.
Endometriosis may not affect the tumor response or the prognosis of OCCC patients.
尽管卵巢透明细胞癌（OCCC）与子宫内膜异位症之间存在关联，但子宫内膜异位症是否会影响OCCC的预后仍存在争议。我们进行了一项双中心队列研究和荟萃分析，以探讨子宫内膜异位症对OCCC预后的影响。
本研究回顾了1997年至2012年期间在两家三级医疗中心收治的109例OCCC患者的临床病理资料，其中47例患者的OCCC发生于子宫内膜异位症，62例患者的OCCC未发生于子宫内膜异位症。比较两组患者的肿瘤反应和生存率。为了进一步评估，我们检索了PubMed、EmBase和Cochrane图书馆，并对1996年3月至2014年5月发表的10项队列研究进行了荟萃分析，包括本队列研究。
发生于子宫内膜异位症的OCCC患者与未发生子宫内膜异位症的患者之间的完全缓解率无差异（77.5%对87.3%；P = 0.444）。早期疾病和最佳肿瘤细胞减灭术是降低不完全缓解风险的唯一独立因素（校正比值比分别为0.203和0.038；95%置信区间[CI]分别为0.045 - 0.920和0.006 - 0.226）。两组患者的无进展生存期（PFS）和总生存期（OS）无差异。早期疾病和最佳肿瘤细胞减灭术是改善PFS（校正风险比[HRs]分别为0.216和0.332；95%CI分别为0.099 - 0.469和0.150 - 0.732）和OS（校正HRs分别为0.099和0.339；95%CI分别为0.039 - 0.252和0.141 - 0.815）的唯一有利因素。此外，粗略和亚组荟萃分析显示，子宫内膜异位症对OCCC患者的PFS或OS无影响。
子宫内膜异位症可能不影响OCCC患者的肿瘤反应或预后。
