Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Gynecol Oncol. 2015 Jun;137(3):412-7. doi: 10.1016/j.ygyno.2015.03.058. Epub 2015 Apr 11.
To demonstrate the survival impact of intraoperative tumor rupture in women with stage I clear cell carcinoma (CCC) of the ovary.
A total of 193 patients with stage I CCC of the ovary who had undergone a complete staging operation followed by ≥three cycles of adjuvant platinum-based chemotherapy, were retrospectively reviewed. Survival analysis was performed and compared between three stage groups: IA/IB, IC1, and IC2/IC3.
There were 70, 51, and 72 women with ovarian CCC in stages IA/IB, IC1, and IC2/IC3, respectively. Intraoperative tumor rupture occurred in 69 (35.8%) patients. Gross endometriosis (p=0.020) and significant peritumoral adhesion (p<0.001) were associated with intraoperative tumor rupture. However, neither laparoscopic approach nor large tumor size >10cm were associated with intraoperative tumor rupture. Patients with stage IC2/IC3 compared to those with stage IC1, had poorer progression-free survival (PFS) (5-year PFS, 68.5% versus 91.7%; p=0.010) and overall survival (OS) (5-year OS, 81.1% versus 95.4%; p=0.027). However, there was no significant difference between patients with stages IA/IB and IC1 CCC in PFS (5-year PFS 88.8% versus 91.7%; p=0.291) and OS (5-year OS 94.6% versus 95.4%; p=0.444). Stage IC2/IC3 was the only independent poor prognostic factor for OS (hazard ratio, 3.50; 95% confidence interval, 1.31 to 9.36).
Surgical spillage of tumor cells does not appear to have a negative impact on survival outcomes of women with stage I ovarian CCC who received ≥three cycles of adjuvant platinum-based chemotherapy.
展示术中肿瘤破裂对 I 期卵巢透明细胞癌（CCC）女性患者生存的影响。
回顾性分析了 193 名接受完整分期手术且术后接受≥3 个周期含铂辅助化疗的 I 期卵巢 CCC 患者。对三组分期（IA/IB、IC1 和 IC2/IC3）的生存情况进行分析和比较。
IA/IB、IC1 和 IC2/IC3 期卵巢 CCC 患者分别为 70、51 和 72 例。术中肿瘤破裂发生于 69 例（35.8%）患者。大体子宫内膜异位症（p=0.020）和明显的肿瘤周围粘连（p<0.001）与术中肿瘤破裂有关。然而，腹腔镜方法或肿瘤较大（>10cm）均与术中肿瘤破裂无关。与 IC1 期患者相比，IC2/IC3 期患者无进展生存期（PFS）（5 年 PFS，68.5%比 91.7%；p=0.010）和总生存期（OS）（5 年 OS，81.1%比 95.4%；p=0.027）较差。然而，IA/IB 期和 IC1 期 CCC 患者的 PFS（5 年 PFS 88.8%比 91.7%；p=0.291）和 OS（5 年 OS 94.6%比 95.4%；p=0.444）无显著差异。IC2/IC3 期是 OS 的唯一独立不良预后因素（风险比，3.50；95%置信区间，1.31 至 9.36）。
对于接受≥3 个周期含铂辅助化疗的 I 期卵巢 CCC 患者，肿瘤细胞的手术溢出似乎不会对生存结果产生负面影响。
