Takahashi Akimasa, Kato Kazuyoshi, Matsuura Motoki, Katsuda Takahiro, Matoda Maki, Nomura Hidetaka, Okamoto Sanshiro, Kanao Hiroyuki, Kondo Eiji, Omatsu Kohei, Utsugi Kuniko, Takeshima Nobuhiro
Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
Medicine (Baltimore). 2017 Sep;96(37):e8006. doi: 10.1097/MD.0000000000008006.
To compare secondary cytoreductive surgery (SCS) plus chemotherapy with chemotherapy alone in Japanese patients with recurrent epithelial ovarian, tubal, or peritoneal cancer (ROC).From our institutional database, we identified 112 patients who underwent therapy for ROC between 2005 and 2013. Of the 112 patients, 77 received salvage chemotherapy alone (CT group) and 35 received SCS plus chemotherapy (SCS group). To reduce the impact of treatment selection bias on treatment outcomes, propensity score-matching analysis was used.In the entire cohort, prognostic features were poorer in the CT group than in the SCS group. The platinum-free interval was significantly lower (15.35 months vs 30.77 months), cancer antigen 125 (CA125) level was significantly higher (247.38 IU/mL vs 83.17 IU/mL), and number of solitary recurrence sites was significantly lower in the CT group than in the SCS group. The matched cohort consisted of 29 CT and 29 SCS patients with a median follow-up period of 24 and 58 months, respectively. In the matched cohort, progression-free survival (PFS) was longer in the SCS group than in the CT group (P = .02); however, overall survival did not differ (P = .23).SCS might be associated with improved PFS in ROC patients. SCS is beneficial in appropriately selected ROC patients.
比较二次细胞减灭术(SCS)联合化疗与单纯化疗对日本复发性上皮性卵巢癌、输卵管癌或腹膜癌(ROC)患者的疗效。我们从机构数据库中确定了2005年至2013年间接受ROC治疗的112例患者。在这112例患者中,77例仅接受挽救性化疗(CT组),35例接受SCS联合化疗(SCS组)。为减少治疗选择偏倚对治疗结果的影响,采用倾向评分匹配分析。在整个队列中,CT组的预后特征比SCS组差。CT组的无铂间期显著缩短(15.35个月对30.77个月),癌抗原125(CA125)水平显著升高(247.38 IU/mL对83.17 IU/mL),且孤立复发部位数量显著少于SCS组。匹配队列包括29例CT组患者和29例SCS组患者,中位随访期分别为24个月和58个月。在匹配队列中,SCS组的无进展生存期(PFS)长于CT组(P = 0.02);然而,总生存期无差异(P = 0.23)。SCS可能与改善ROC患者的PFS相关。SCS对适当选择的ROC患者有益。