Department of Gynecologic Oncology, Faculty of Medicine, Zekai Tahir Burak Women's Health Research and Training Hospital, University of Health Sciences, Zekai Tahir Burak Kadın Saglıgı Egitim ve Arastırma Hastanesi, Talatpasa Bulvarı, Altındag, 06230, Ankara, Turkey.
Department of Gynecologic Oncology, Faculty of Medicine, Etlik Zubeyde Hanim Women's Health Research and Training Hospital, University of Health Sciences, Etlik Mahallesi, Yeni Etlik Caddesi No: 55, 06010, Ankara, Turkey.
Int J Clin Oncol. 2018 Apr;23(2):329-337. doi: 10.1007/s10147-017-1215-x. Epub 2017 Nov 16.
OBJECTIVE: The purpose of this retrospective study was to compare the prognoses of women with ovarian carcinosarcoma (OCS) who had optimal cytoreductive surgery followed by platinum plus taxane combination chemotherapy to those of women with ovarian high-grade serous carcinoma (HGSC) treated in the same manner. METHODS: A multicenter, retrospective department database review was performed to identify patients with OCS at eight gynecologic oncology centers in Turkey. A total of 54 women with OCS who had undergone optimal cytoreductive surgery followed by platinum plus taxane combination chemotherapy between 1999 and 2017 were included in this case-control study. Each case was matched to two women with ovarian HGSC who had undergone optimal cytoreductive surgery followed by platinum plus taxane combination chemotherapy. The Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analysed using Cox proportional hazards models. RESULTS: Median disease-free survival (DFS) was 29 months [95% confidence interval (CI) 0-59, standard error (SE) 15.35] versus 27 months (95% CI 22.6-31.3, SE 2.22; p = 0.765) and median overall survival (OS) was 62 versus 82 months (p = 0.53) for cases and controls, respectively. For the entire cohort, the presence of ascites [hazard ratio (HR) 2.32; 95% CI 1.02-5.25, p = 0.04] and platinum resistance [HR 5.05; 95% CI 2.32-11, p < 0.001] were found to be independent risk factors for decreased OS. CONCLUSION: DFS and OS rates of patients with OCS and HGSC seem to be similar whenever optimal cytoreduction is achieved and followed by platinum plus taxane combination chemotherapy.
目的：本回顾性研究旨在比较行满意肿瘤细胞减灭术（optimal cytoreductive surgery）后接受铂类加紫杉烷类联合化疗的卵巢癌肉瘤（ovarian carcinosarcoma，OCS）患者与接受相同治疗的卵巢高级别浆液性癌（ovarian high-grade serous carcinoma，HGSC）患者的预后。
方法：对土耳其 8 个妇科肿瘤中心的多中心回顾性科室数据库进行了回顾，以确定 OCS 患者。纳入了 1999 年至 2017 年间接受满意肿瘤细胞减灭术联合铂类加紫杉烷类联合化疗的 54 例 OCS 患者。将每位患者与接受满意肿瘤细胞减灭术联合铂类加紫杉烷类联合化疗的 2 例卵巢 HGSC 患者进行匹配。采用 Kaplan-Meier 法生成生存数据。采用 Cox 比例风险模型分析预测结局的因素。
结果：中位无疾病生存（disease-free survival，DFS）为 29 个月（95%置信区间 0-59，标准误差 15.35），中位总生存（overall survival，OS）为 62 个月（95%置信区间 57-67，标准误差 2.82）。对于整个队列，腹水的存在（风险比 hazard ratio，HR 2.32；95%置信区间 1.02-5.25，p=0.04）和铂类耐药（HR 5.05；95%置信区间 2.32-11，p<0.001）是 OS 降低的独立危险因素。
结论：只要达到满意的肿瘤细胞减灭术并随后接受铂类加紫杉烷类联合化疗，OCS 和 HGSC 患者的 DFS 和 OS 率似乎相似。
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