Kaban Alpaslan, Topuz Samet, Saip Pınar, Sözen Hamdullah, Salihoğlu Yavuz
Division of Gynecologic Oncology, Department Of Obstetrics and Gynecology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Division of Gynecologic Oncology, Department Of Obstetrics and Gynecology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
J Obstet Gynaecol Can. 2018 Apr;40(4):447-453. doi: 10.1016/j.jogc.2017.07.026. Epub 2017 Oct 18.
The aim of the study is to investigate factors related to overall survival in advanced stage ovarian, tubal, or peritoneal cancer and to identify strong and weak prognostic factors.
We retrospectively reviewed 190 patients who underwent primary cytoreductive surgery between 2003 and 2013.
Median overall survival duration was founded 58 months (95% CI 49-67). Five-year overall survival ratio was 48.5%. Presence of tumour at upper abdomen, suboptimal cytoreduction (residual >1 cm), surgery without lymphadenectomy, and presence of peritoneal ascites more than 1 L had a significantly negative effect on overall survival, but not histological grade and CA-125 level, by univariate Cox analysis. Age and presence of tumour in the upper abdomen were independent poor prognostic factors according to multivariate Cox model (HR 1.025; 95% CI 1.009-1.040 and HR 1.533; 95% CI 1.039-2.263, respectively).
This study supports that the presence of tumour in the upper abdomen is the most important independent poor prognostic factor in patients with performed primary surgery for advanced stage ovarian, tubal, and peritoneal cancer. Upper abdominal metastasis is the most important predictive factor for optimal cytoreduction (P <0.001, HR 6.567; 95% CI 3.059-14.096).
本研究旨在调查晚期卵巢癌、输卵管癌或腹膜癌患者总生存相关因素,并识别强、弱预后因素。
我们回顾性分析了2003年至2013年间接受初次肿瘤细胞减灭术的190例患者。
中位总生存时间为58个月(95%可信区间49 - 67个月)。5年总生存率为48.5%。单因素Cox分析显示,上腹部存在肿瘤、细胞减灭术未达最优(残留>1 cm)、未行淋巴结清扫术以及腹膜腹水超过1 L对总生存有显著负面影响,但组织学分级和CA-125水平无此影响。根据多因素Cox模型,年龄和上腹部存在肿瘤是独立的不良预后因素(风险比分别为1.025;95%可信区间1.009 - 1.040和1.533;95%可信区间1.039 - 2.263)。
本研究支持上腹部存在肿瘤是晚期卵巢癌、输卵管癌和腹膜癌患者初次手术后最重要的独立不良预后因素。上腹部转移是实现最优细胞减灭术的最重要预测因素(P < 0.001,风险比6.567;95%可信区间3.059 - 14.096)。