Kajiyama Hiroaki, Suzuki Shiro, Yoshihara Masato, Nishino Kimihiro, Yoshikawa Nobuhisa, Utsumi Fumi, Niimi Kaoru, Mizuno Mika, Kawai Michiyasu, Oguchi Hidenori, Mizuno Kimio, Yamamuro Osamu, Nagasaka Tetsuro, Shibata Kiyosumi, Kikkawa Fumitaka
Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Department of Gynecology, Aichi Cancer Center Hospital, Nagoya, Japan.
Oncotarget. 2018 Jan 4;9(5):6298-6307. doi: 10.18632/oncotarget.23921. eCollection 2018 Jan 19.
The objective of this study was to estimate the frequency of possible occult metastasis through long-term survival analyses in patients with clear cell carcinoma (CCC) who had undergone complete resection. During the period of 1990-2015, 799 patients with stage I-IV CCC were identified in the TOTSG database. Of these, a total of 528 patients without a residual tumor were enrolled in the study and classified into four groups: Group 1: FIGO stage IA-IB (N=104), Group 2: FIGO stage IC1 (N=170), Group 3: FIGO stage IC2/IC3 (N=98), and Group 4: FIGO stage II-III (no residual tumor: N=156). Cumulative incidences of recurrence (CIR) and death (CID) were examined. The median age was 54, ranging from 29-87. The 5-year CIR / CID of each group were as follows: Group 1 (7.3% / 3.8%), Group 2 (14.3% / 10.2%), Group 3 (37.7% / 18.4%), and Group 4 (46.5% / 33.8%), respectively {<0.0001 (recurrence) / <0.0001 (death)}. Furthermore, confining analysis to relapsed patients, 1-, 2-, and 3-year CID after recurrence were 41.5, 60.9, and 73.9, respectively. Confining analyses to patients with sufficient information about adjuvant chemotherapy, the 5-year CIR / CID of stage IA-IC1 patients with or without chemotherapy were as follows: recurrence {13.0% (yes) / 9.6% (no)}, death {9.3% (yes) / 4.2% (no)}, respectively {=0.947 (CIR) / =0.224 (CID)}. CCC patients staged greater than IC2/ IC3 show a marked risk of mortality, even after complete surgical resection.
本研究的目的是通过对已接受根治性切除术的透明细胞癌（CCC）患者进行长期生存分析，评估潜在隐匿性转移的发生率。在1990年至2015年期间，TOTSG数据库中识别出799例I-IV期CCC患者。其中，共有528例无残留肿瘤的患者纳入本研究，并分为四组：第1组：国际妇产科联盟（FIGO）IA-IB期（N = 104），第2组：FIGO IC1期（N = 170），第3组：FIGO IC2/IC3期（N = 98），第4组：FIGO II-III期（无残留肿瘤：N = 156）。检查复发累积发生率（CIR）和死亡累积发生率（CID）。中位年龄为54岁，范围为29至87岁。各组的5年CIR/CID如下：第1组（7.3% / 3.8%），第2组（14.3% / 10.2%），第3组（37.7% / 18.4%），第4组（46.5% / 33.8%），{复发<0.0001 / 死亡<0.0001}。此外，仅对复发患者进行分析，复发后1年、2年和3年的CID分别为41.5%、60.9%和73.9%。仅对有足够辅助化疗信息的患者进行分析，IA-IC1期接受或未接受化疗患者的5年CIR/CID如下：复发{13.0%（是）/ 9.6%（否）}，死亡{9.3%（是）/ 4.2%（否）}，{CIR = 0.947 / CID = 0.224}。分期大于IC2/IC3的CCC患者即使在根治性手术后也显示出明显的死亡风险。
