诊断中心会影响接受新辅助化疗的卵巢癌患者的预后吗？
Does the diagnosis center influence the prognosis of ovarian cancer patients submitted to neoadjuvant chemotherapy?
作者信息
Vizzielli Giuseppe, Fanfani Francesco, Chiantera Vito, Tortorella Lucia, Lucidi Alessandro, Petrillo Marco, Costantini Barbara, Scambia Giovanni, Fagotti Anna
机构信息
Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy
Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
出版信息
Anticancer Res. 2015 May;35(5):3027-32.
AIM
To compare prognosis of advanced epithelial ovarian cancer (AEOC) patients based on where the first surgical assessment was performed.
PATIENTS AND METHODS
Retrospective analysis of primary AEOC patients was performed and three groups were formed based on where the decision of primary treatment was taken: Internal, if the decision was carried out at our Institution (PDS (Primary Debulking Surgery), I-IDS (Internal-Interval Debulking Surgery)) and Referred in case women were referred after neoadjuvant chemotherapy (NACT) from other Centers (R-IDS (Referred-Interval Debulking Surgery)).
RESULTS
Among 573 AEOC, 279 (48.7%) were PDS and 294 (51.3%) IDS. In particular, 134 of 294 (45.6%) were R-IDS and 160 (54.4%) were I-IDS. Median progression-free survival (PFS) was 26 months in PDS, 14 months in I-IDS and 17 months in R-IDS. The difference was statistically significant (p<0.05) among all groups.
CONCLUSION
IDS can represent a suitable approach only when the first complete debulking is not achievable in a tertiary referral hospital.
目的
根据首次手术评估的地点比较晚期上皮性卵巢癌（AEOC）患者的预后。
患者与方法
对原发性AEOC患者进行回顾性分析，并根据首次治疗决策的地点分为三组：内部组，如果决策在我们机构进行（PDS（初次肿瘤细胞减灭术），I-IDS（内部间隔肿瘤细胞减灭术））；转诊组，如果患者在接受新辅助化疗（NACT）后从其他中心转诊而来（R-IDS（转诊间隔肿瘤细胞减灭术））。
结果
在573例AEOC患者中，279例（48.7%）接受了PDS，294例（51.3%）接受了IDS。其中，294例中的134例（45.6%）为R-IDS，160例（54.4%）为I-IDS。PDS组的中位无进展生存期（PFS）为26个月，I-IDS组为14个月，R-IDS组为17个月。所有组之间的差异具有统计学意义（p<0.05）。
结论
仅当在三级转诊医院无法实现首次完全肿瘤细胞减灭时，IDS才可能是一种合适的方法。
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