Kaban Alpaslan, Topuz Samet, Saip Pinar, Sozen Hamdullah, Celebi Koray, Salihoglu Yavuz
Obstetrics and Gynecology, Department of Gynecological Oncology Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
Obstetrics and Gynecology, Department of Gynecological Oncology Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
J Obstet Gynaecol Can. 2017 Dec;39(12):1163-1170. doi: 10.1016/j.jogc.2017.05.008. Epub 2017 Aug 4.
To investigate the survival-related factors of patients with advanced stage ovarian cancer who underwent debulking surgery after neoadjuvant chemotherapy (NAC).
Two hundred three patients with stage IIIC to IV ovarian cancer who underwent debulking surgery after NAC between 2002 and 2012 were retrospectively analyzed. Overall survival-associated factors, including the performance of optimal surgery, the timing of NAC cycles, the presence of tumour regression according to the pathology report, and lymphadenectomy, were explored using logistic regression analyses.
Of the 203 patients, 82% (n = 165) underwent optimal surgery. The median follow-up time was 34 months (range 1-124), and the median overall survival was 37.5 months (95% CI 32.6-42.3). The 5-year overall survival rate was 31.3%. Performance of optimal surgery; <4 NAC cycles; presence of tumour regression (either macroscopically, microscopically, or no tumour present) in the omentum according to the pathology report; and lymphadenectomy were found to be statistically significant based on a univariate Cox analysis. Of these factors, >1 cm residual tumour, no tumour regression in the omentum according to the pathology report, and >4 NAC cycles were significant predictors of a poor prognosis based on a multivariate Cox model (hazard ratio [HR] 1.62, 95% CI 1.02-2.59; HR 2.07, 95% CI 1.36-3.17; HR 1.55, 95% CI 1.07-2.34, respectively).
Results of the study support that >1 cm residual tumour at the end of the surgery, the presence of a macroscopic tumour in the omentum, and >4 NAC cycles were independent poor prognostic factors in patients with advanced stage ovarian, tubal, or peritoneal cancer who underwent surgery after NAC.
探讨接受新辅助化疗（NAC）后行肿瘤细胞减灭术的晚期卵巢癌患者的生存相关因素。
回顾性分析2002年至2012年间203例IIIC期至IV期卵巢癌患者，这些患者在接受NAC后行肿瘤细胞减灭术。采用逻辑回归分析探讨与总生存相关的因素，包括理想手术的实施情况、NAC周期的时间、根据病理报告判断的肿瘤退缩情况以及淋巴结清扫术。
203例患者中，82%（n = 165）接受了理想手术。中位随访时间为34个月（范围1 - 124个月），中位总生存时间为37.5个月（95%CI 32.6 - 42.3）。5年总生存率为31.3%。单因素Cox分析显示，理想手术的实施情况、<4个NAC周期、根据病理报告大网膜存在肿瘤退缩（无论是宏观上、微观上还是无肿瘤残留）以及淋巴结清扫术具有统计学意义。在这些因素中，基于多因素Cox模型，>1 cm残留肿瘤、根据病理报告大网膜无肿瘤退缩以及>4个NAC周期是预后不良的显著预测因素（风险比[HR]分别为1.62，95%CI 1.02 - 2.59；HR 2.07，95%CI 1.36 - 3.17；HR 1.55，95%CI 1.0
