Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Gynecol Oncol. 2018 Jan;29(1):e13. doi: 10.3802/jgo.2018.29.e13.
We compared survival outcomes of advanced serous type epithelial ovarian cancer (EOC) patients with normal-sized ovaries and enlarged-ovarian tumors by propensity score matching analysis.
The medical records of EOC patients treated at Samsung Medical Center between 2002 and 2015 were reviewed retrospectively. We investigated EOC patients with high grade serous type histology and International Federation of Gynecology and Obstetrics (FIGO) stage IIIB, IIIC, or IV who underwent primary debulking surgery (PDS) and adjuvant chemotherapy to identify patients with normal-sized ovaries. Propensity score matching was performed to compare patients with normal-sized ovaries to patients with enlarged-ovarian tumors (ratio, 1:3) according to age, FIGO stage, initial cancer antigen (CA)-125 level, and residual disease status after PDS.
Of the 419 EOC patients, 48 patients had normal-sized ovary. Patients with enlarged-ovarian tumor were younger (54.0±10.3 vs. 58.4±9.2 years, p=0.005) than those with normal-sized ovary, and there was a statistically significant difference in residual disease status between the 2 groups. In total cohort with a median follow-up period of 43 months (range, 3-164 months), inferior overall survival (OS) was shown in the normal-sized ovary group (median OS, 71.2 vs. 41.4 months; p=0.003). After propensity score matching, the group with normal-sized ovary showed inferior OS compared to the group with enlarged-ovarian tumor (median OS, 72.1 vs. 41.4 months; p=0.031). In multivariate analysis for OS, normal-sized ovary remained a significant factor.
Normal-sized ovary was associated with poor OS compared with the common presentation of enlarged ovaries in EOC, independent of CA-125 level or residual disease.
我们通过倾向评分匹配分析比较了具有正常大小卵巢和增大卵巢肿瘤的晚期浆液性上皮性卵巢癌（EOC）患者的生存结果。
回顾性分析了 2002 年至 2015 年在三星医疗中心接受治疗的 EOC 患者的病历。我们调查了具有高级别浆液性组织学和国际妇产科联合会（FIGO）IIIb、IIIC 或 IV 期的 EOC 患者，这些患者接受了初次减瘤手术（PDS）和辅助化疗，以确定具有正常大小卵巢的患者。根据年龄、FIGO 分期、初始癌抗原（CA）-125 水平和 PDS 后残留疾病状态，对具有正常大小卵巢的患者与具有增大卵巢肿瘤的患者（比例为 1:3）进行倾向评分匹配。
在 419 名 EOC 患者中，有 48 名患者具有正常大小的卵巢。与具有正常大小卵巢的患者相比，具有增大卵巢肿瘤的患者年龄更小（54.0±10.3 岁 vs. 58.4±9.2 岁，p=0.005），两组之间的残留疾病状态存在统计学差异。在总队列中，中位随访时间为 43 个月（范围 3-164 个月），具有正常大小卵巢的患者总生存期（OS）较差（中位 OS，71.2 个月 vs. 41.4 个月；p=0.003）。在倾向评分匹配后，与具有增大卵巢肿瘤的患者相比，具有正常大小卵巢的患者 OS 更差（中位 OS，72.1 个月 vs. 41.4 个月；p=0.031）。在 OS 的多变量分析中，正常大小的卵巢仍然是一个重要的因素。
与 EOC 中常见的增大卵巢表现相比，正常大小的卵巢与较差的 OS 相关，独立于 CA-125 水平或残留疾病。
