Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Shuaifuyuan 1, Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
J Ovarian Res. 2017 Oct 3;10(1):67. doi: 10.1186/s13048-017-0363-y.
Clinico-pathological characteristics and possible prognostic factors among women with epithelial ovarian carcinoma (EOC) with or without concurrent endometriosis were explored.
We retrospectively identified 304 patients with EOC treated primarily at Peking Union Medical College Hospital with median follow-up time of 60 months.
Of 304 patients with EOC, concurrent endometriosis was identified in 69 (22.7%). The patients with concurrent endometriosis were younger and more probably post-menopausal at onset, were less likely to have abdominal distension, with significantly lower level of pre-surgery serum Ca125 and less possibility of having the history of tubal ligation. The women with concurrent endometriosis group were more likely to have early stage tumors (88.41% versus 52.77%), receive optimal cytoreductive surgery (92.75% versus 71.06%), and less likely to have lymph node metastasis or to develop platinum resistance disease (7.25% versus 14.89%, and 7.35% versus 20%), when compared with women without coexisting endometriosis. The univariate analysis showed that concurrent endometriosis was a prognostic factor for overall survival (OS) and disease-free survival (DFS), but this association just remained in the DFS by multivariate analysis. Besides, multivariate analysis also showed that FIGO stage, residual disease, chemotherapy cycles, chemotherapy resistance and concomitant hypertension were the independent impact factors of OS for EOC patients; whereas FIGO stage, lymphadenectomy, residual disease, coexisting endometriosis and chemoresistance were independent impact factors of DFS for those patients.
EOC patients with concurrent endometriosis showed distinct characteristics and had longer overall survival and disease-free survival when compared with those without endometriosis. Endometriosis was the independent prognostic factor for DFS for patients in this series.
本研究旨在探讨合并与不合并子宫内膜异位症的上皮性卵巢癌（EOC）患者的临床病理特征和可能的预后因素。
我们回顾性分析了 304 例在北京协和医院接受治疗的 EOC 患者，中位随访时间为 60 个月。
在 304 例 EOC 患者中，69 例（22.7%）合并子宫内膜异位症。合并子宫内膜异位症的患者年龄更小，发病时更可能处于绝经后状态，腹部膨胀的可能性更小，术前血清 CA125 水平明显更低，且输卵管结扎史的可能性更小。与不合并子宫内膜异位症的患者相比，合并子宫内膜异位症的患者更有可能为早期肿瘤（88.41% vs. 52.77%），接受理想的肿瘤细胞减灭术（92.75% vs. 71.06%），且淋巴结转移或铂类耐药性疾病的发生率更低（7.25% vs. 14.89%，7.35% vs. 20%）。单因素分析显示，合并子宫内膜异位症是总生存（OS）和无病生存（DFS）的预后因素，但多因素分析仅显示该关联存在于 DFS 中。此外，多因素分析还显示，FIGO 分期、残留病灶、化疗周期、化疗耐药和合并高血压是 EOC 患者 OS 的独立影响因素；而 FIGO 分期、淋巴结切除术、残留病灶、合并子宫内膜异位症和化疗耐药是这些患者 DFS 的独立影响因素。
与不合并子宫内膜异位症的患者相比，合并子宫内膜异位症的 EOC 患者具有明显不同的特征，其总生存时间和无病生存时间更长。在本研究系列中，子宫内膜异位症是 DFS 的独立预后因素。
