Matsuhashi Tomohiko, Takeshita Toshiyuki, Yamamoto Akihito, Kawase Rieko, Yamada Takashi, Kurose Keisuke, Doi Daisuke, Konnai Katsuyuki, Onose Ryo, Kato Hisamori
Department of Obstetrics and Gynecology, Nippon Medical School Chiba Hokusoh Hospital.
Department of Gynecology, Kanagawa Cancer Center.
J Nippon Med Sch. 2017;84(4):170-176. doi: 10.1272/jnms.84.170.
Recently, neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) has been recommended for selected patients with International Federation of Gynecology and Obstetrics (FIGO) stage III or IV disease and bulky tumors. The aim of this study was to evaluate associations between post-NACT serum CA 125 levels, surgical outcomes, and clinical outcomes in patients with advanced epithelial ovarian cancer. We retrospectively analyzed 107 patients with FIGO stage III or IV ovarian cancer who were treated with NACT-IDS at the Gynecology Department of Kanagawa Cancer Center between January 2001 and December 2012. Serum CA 125 levels after NACT were significantly lower in the complete/optimal IDS group compared to the suboptimal IDS group (mean±standard deviation: 48.1±27.6 vs. 346.5±295.2 U/mL, p<0.01). Patients with low preoperative CA 125 levels (<35 U/mL) had a higher probability of optimal IDS (78.1±41.9% vs. 33.3±19.2%, p<0.01) and longer progression-free survival (mean±standard deviation: 30.4±14.3 months vs. 21.3±7.3 months, p<0.05) than patients with high CA 125 levels (>100 U/mL). Patients with low CA 125 levels (<35 U/mL) had a higher probability of complete/optimal IDS and longer progression-free survival compared to patients with high CA 125 levels (>100 U/mL).
最近，对于国际妇产科联盟（FIGO）III期或IV期疾病且肿瘤体积较大的特定患者，推荐采用新辅助化疗后行间隔减瘤手术（NACT-IDS）。本研究的目的是评估晚期上皮性卵巢癌患者NACT后血清CA 125水平、手术结局和临床结局之间的关联。我们回顾性分析了2001年1月至2012年12月在神奈川癌症中心妇科接受NACT-IDS治疗的107例FIGO III期或IV期卵巢癌患者。与次优减瘤手术组相比，完全/最优减瘤手术组NACT后的血清CA 125水平显著更低（均值±标准差：48.1±27.6 vs. 346.5±295.2 U/mL，p<0.01）。术前CA 125水平低（<35 U/mL）的患者比CA 125水平高（>100 U/mL）的患者有更高的概率接受最优减瘤手术（78.1±41.9% vs. 33.3±19.2%，p<0.01）且无进展生存期更长（均值±标准差：30.4±14.3个月 vs. 21.3±7.3个月，p<0.05）。与CA 125水平高（>100 U/mL）的患者相比，CA 125水平低（<35 U/mL）的患者有更高的概率接受完全/最优减瘤手术且无进展生存期更长。
