Utsumi Fumi, Kajiyama Hiroaki, Niimi Kaoru, Sekiya Ryuichiro, Sakata Jun, Suzuki Shiro, Shibata Kiyosumi, Mizuno Mika, Kikkawa Fumitaka
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan.
J Obstet Gynaecol Res. 2017 Feb;43(2):365-370. doi: 10.1111/jog.13219.
Women with ovarian cancer (OC) often experience relapse and receive further repetitive chemotherapy. The objective of this study was to overview the remaining survival time after the final chemotherapy and to examine influential clinicopathologic indicators in those patients.
The medical charts of deceased OC patients who had died of the disease between 2003 and 2012 were retrospectively reviewed. We investigated post-cancer-treatment survival (PCS) defined as the interval between the date of the final chemotherapy and death.
In all, 77 patients were enrolled. Three patients (3.9%) had received chemotherapy in the last 2 weeks. Eight (10.4%), 28 (36.4%), and 44 (57.2%) patients had received chemotherapy in the last 30, 60, and 90 days, respectively. There were no differences in either survival after recurrence or overall survival between the shorter (<75 days) and longer (≥75 days) PCS groups. On the other hand, patients in the shorter PCS group had significantly fewer chances of referral to a hospice or home-care than those in the latter group (P = 0.035). In multivariable analysis, a poorer performance status, an elevated white blood cell count, and a higher C-reactive protein value were significantly correlated with a shorter PCS (P = 0.004, 0.006 and 0.027, respectively).
Half of the patients received chemotherapy within 75 days of death and we did not identify any survival benefit in patients who received chemotherapy near the end of life. We should provide information to patients about their prognosis and discuss the timing of withdrawal from chemotherapy from the early stage of their recurrence.
卵巢癌（OC）女性患者常经历复发并接受进一步的重复化疗。本研究的目的是概述末次化疗后的剩余生存时间，并检查这些患者中有影响的临床病理指标。
回顾性分析2003年至2012年间死于该疾病的OC患者的病历。我们调查了癌症治疗后生存期（PCS），定义为末次化疗日期与死亡日期之间的间隔。
共纳入77例患者。3例患者（3.9%）在死前最后2周接受了化疗。分别有8例（10.4%）、28例（36.4%）和44例（57.2%）患者在死前最后30天、60天和90天接受了化疗。PCS较短（<75天）组和较长（≥75天）组在复发后的生存率或总生存率方面均无差异。另一方面，PCS较短组患者转诊至临终关怀机构或接受家庭护理的机会明显少于后者（P = 0.035）。多变量分析显示，较差的体能状态、白细胞计数升高和较高的C反应蛋白值与较短的PCS显著相关（分别为P = 0.004、0.006和0.027）。
一半的患者在死亡前75天内接受了化疗，我们未发现临终时接受化疗的患者有任何生存获益。我们应从患者复发的早期就向其提供预后信息，并讨论停止化疗的时机。
