Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA.
University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA.
BMC Cancer. 2018 Feb 9;18(1):172. doi: 10.1186/s12885-018-4082-6.
The optimal first-line chemotherapy for ovarian carcinosarcoma has not yet been determined. We therefore sought to determine the progression-free survival (PFS) and overall survival (OS) for patients with ovarian carcinosarcoma treated at our institution with different first-line chemotherapy regimens.
This single-institution, retrospective analysis included all patients with ovarian or primary peritoneal carcinosarcoma diagnosed from September 1996 to July 2017. Kaplan Meier analysis with a log-rank Mantel-Cox test was used to compare PFS and OS between treatment groups, and a p-value of < 0.05 was considered statistically significant.
Thirty-one patients met inclusion criteria: two patients were stage IC, 5 were stage II, 21 were stage III, and 3 were stage IV. The median PFS and OS for all stages was 9.3 and 19.7 months respectively. Fifteen patients (48%) received carboplatin/paclitaxel as first therapy, 7 (23%) received ifosfamide/paclitaxel, 6 (19%) received a different regimen, and 3 (10%) did not receive chemotherapy. Patients treated with carboplatin/paclitaxel had a statistically significant longer PFS when compared to those receiving ifosfamide/paclitaxel (17.8 vs. 8.0 months, p = 0.025). OS was similar between all comparisons.
In summary, in our cohort of ovarian carcinosarcoma patients, median PFS is longer in patients treated with carboplatin/paclitaxel compared to ifosfamide/paclitaxel. Overall survival was similar for all treatment groups, potentially due to subsequent treatment crossover. Given the rarity and aggressive nature of this tumor, further study into optimal first-line chemotherapy is warranted.
卵巢癌肉瘤的最佳一线化疗方案尚未确定。因此，我们旨在确定在我院接受不同一线化疗方案治疗的卵巢癌肉瘤患者的无进展生存期（PFS）和总生存期（OS）。
本单中心回顾性分析纳入了 1996 年 9 月至 2017 年 7 月期间诊断为卵巢或原发性腹膜癌肉瘤的所有患者。采用 Kaplan-Meier 分析和对数秩 Mantel-Cox 检验比较治疗组之间的 PFS 和 OS，p 值<0.05 为统计学显著差异。
31 例患者符合纳入标准：2 例为 IC 期，5 例为 II 期，21 例为 III 期，3 例为 IV 期。所有分期的中位 PFS 和 OS 分别为 9.3 个月和 19.7 个月。15 例（48%）患者接受卡铂/紫杉醇作为一线治疗，7 例（23%）接受异环磷酰胺/紫杉醇，6 例（19%）接受其他方案，3 例（10%）未接受化疗。与接受异环磷酰胺/紫杉醇治疗的患者相比，接受卡铂/紫杉醇治疗的患者 PFS 有显著延长（17.8 个月 vs. 8.0 个月，p=0.025）。所有比较中 OS 相似。
总之，在我们的卵巢癌肉瘤患者队列中，与接受异环磷酰胺/紫杉醇治疗的患者相比，接受卡铂/紫杉醇治疗的患者中位 PFS 更长。由于接受后续治疗交叉，所有治疗组的总生存期相似。鉴于该肿瘤的罕见性和侵袭性，需要进一步研究最佳一线化疗方案。
