Bouchard-Fortier Geneviève, Panzarella Tony, Rosen Barry, Chapman William, Gien Lilian T
Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
Biostatistics Department, Princess Margaret Cancer Centre, Toronto ON.
J Obstet Gynaecol Can. 2017 Jan;39(1):34-41. doi: 10.1016/j.jogc.2016.10.006. Epub 2016 Dec 10.
The prognostic significance of endometrioid ovarian cancer is unclear. In this study we compared rates of overall survival (OS) and disease-free survival between patients with endometrioid and serous ovarian cancers using long-term follow-up data.
We included patients with endometrioid or serous ovarian cancers diagnosed at a single regional cancer centre between 1988 and 2006. Data on baseline and treatment characteristics were collected retrospectively. We used multivariate Cox proportional hazard models to determine the independent effect of histology on death or recurrence, adjusting for age, tumour grade, primary cytoreductive surgery, year of diagnosis, adjuvant treatment, and stage.
Five hundred and thirty-three women with ovarian cancer were included in the study cohort; 98 (18.4%) had endometrioid histology and 435 (81.6%) serous histology. The five-year OS rate for women with endometrioid cancer was 80.6%, and for women with serous ovarian cancer, it was 35.0%. The 10-year OS rates were 68.4% and 18.4% for endometrioid and serous histology, respectively. After adjusting for confounders excluding stage, there was a significantly lower risk of death from endometrioid cancer compared to serous ovarian cancer (hazard ratio [HR] 0.41, 95% CI 0.26 to 0.66). However, the difference was no longer significant after adding tumour stage to the model (HR 0.74, 95% CI 0.45 to 1.24). We found similar results for the risk of recurrence (HR 0.41, 95% CI 0.27 to 0.62 with stage not included, compared to HR 0.77, 95% CI 0.49 to 1.21 with stage included).
In this large cohort, in comparison with women with serous ovarian cancer, women with endometrioid ovarian cancer presented at a younger age, had earlier stage disease, and had disease almost always confined to the pelvis. The earlier stage of presentation of endometrioid ovarian cancer resulted in improved five-year and 10-year OS rates compared to serous ovarian cancer.
子宫内膜样卵巢癌的预后意义尚不清楚。在本研究中，我们使用长期随访数据比较了子宫内膜样和浆液性卵巢癌患者的总生存率（OS）和无病生存率。
我们纳入了1988年至2006年间在单个地区癌症中心诊断为子宫内膜样或浆液性卵巢癌的患者。回顾性收集基线和治疗特征数据。我们使用多变量Cox比例风险模型来确定组织学对死亡或复发的独立影响，并对年龄、肿瘤分级、初次细胞减灭术、诊断年份、辅助治疗和分期进行调整。
研究队列纳入了533例卵巢癌女性患者；98例（18.4%）为子宫内膜样组织学类型，435例（81.6%）为浆液性组织学类型。子宫内膜样癌女性的五年总生存率为80.6%，浆液性卵巢癌女性为35.0%。子宫内膜样和浆液性组织学类型的10年总生存率分别为68.4%和18.4%。在调整除分期外的混杂因素后，与浆液性卵巢癌相比，子宫内膜样癌的死亡风险显著降低（风险比[HR]0.41，95%可信区间0.26至0.66）。然而，在模型中加入肿瘤分期后，差异不再显著（HR 0.74，95%可信区间0.45至1.24）。我们在复发风险方面发现了类似的结果（不包括分期时HR 0.41，95%可信区间0.27至0.62，与包括分期时HR 0.77，95%可信区间0.49至1.21相比）。
在这个大型队列中，与浆液性卵巢癌女性相比，子宫内膜样卵巢癌女性发病年龄较轻，疾病分期较早，且疾病几乎总是局限于盆腔。与浆液性卵巢癌相比，子宫内膜样卵巢癌较早的分期导致五年和十年总生存率提高。
