Dao Fanny, Schlappe Brooke A, Tseng Jill, Lester Jenny, Nick Alpa M, Lutgendorf Susan K, McMeekin Scott, Coleman Robert L, Moore Kathleen N, Karlan Beth Y, Sood Anil K, Levine Douglas A
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, New York, United States.
Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Gynecol Oncol. 2016 May;141(2):260-263. doi: 10.1016/j.ygyno.2016.03.010. Epub 2016 Mar 11.
High-grade serous carcinoma (HGSC) generally presents at an advanced stage with poor long-term (LT) survival. Here we describe clinical features found in women surviving HGSC for ten or more years.
A multi-center research consortium was established between five participating academic centers. Patient selection criteria included high-grade serous ovarian, fallopian tube, or peritoneal carcinoma with at least ten years of follow up. Non-serous, borderline tumors and low-grade serous subtypes were excluded.
The 203 identified LT ten-year survivors with HGSC were diagnosed at a median age of 57years (range 37-84years). The majority of patients had stage IIIC (72.4%) disease at presentation. Of those who underwent primary cytoreductive surgery, optimal cytoreduction was achieved in 143 (85.6%) patients. After a median follow up of 144months, 88 (46.8%) patients did not develop recurrent disease after initial treatment. Unexpected findings from this survey of LT survivors includes 14% of patients having had suboptimal cytoreduction, 11% of patients having an initial platinum free interval of <12months, and nearly 53% of patients having recurrent disease, yet still surviving more than ten years after diagnosis.
LT survivors of HGSC of the ovary generally have favorable clinical features including optimal surgical cytoreduction and primary platinum sensitive disease. The majority of patients will develop recurrent disease, however many remained disease free for more than 10years. Future work will compare the clinical features of this unusual cohort of LT survivors with the characteristics of HGSC patients having less favorable outcomes.
高级别浆液性癌(HGSC)通常在晚期出现,长期(LT)生存率较低。在此,我们描述了HGSC存活10年或更长时间的女性患者的临床特征。
在五个参与研究的学术中心之间建立了一个多中心研究联盟。患者选择标准包括高级别浆液性卵巢癌、输卵管癌或腹膜癌,且至少随访10年。非浆液性、交界性肿瘤和低级别浆液性亚型被排除在外。
203名确诊为HGSC的LT十年幸存者的中位年龄为57岁(范围37 - 84岁)。大多数患者在初诊时为IIIC期(72.4%)疾病。在接受初次细胞减灭术的患者中,143名(85.6%)患者实现了最佳细胞减灭。中位随访144个月后,88名(46.8%)患者在初始治疗后未出现复发性疾病。对LT幸存者的这项调查的意外发现包括14%的患者细胞减灭效果欠佳,11%的患者初始无铂间期<12个月,以及近53%的患者出现复发性疾病,但在诊断后仍存活超过10年。
卵巢HGSC的LT幸存者通常具有良好的临床特征,包括最佳手术细胞减灭和原发性铂敏感疾病。大多数患者会出现复发性疾病,然而许多患者在10多年内无疾病复发。未来的工作将比较这一不寻常的LT幸存者队列的临床特征与预后较差的HGSC患者的特征。