Signorelli Mauro, Bogani Giorgio, Chiappa Valentina, Ditto Antonino, Scaffa Cono, Martinelli Fabio, Lorusso Domenica, Raspagliesi Francesco
Unit of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Unit of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy -
Minerva Ginecol. 2018 Aug;70(4):357-363. doi: 10.23736/S0026-4784.18.04221-1. Epub 2018 Mar 30.
The aim of this study was to estimate the rate of ovarian metastases and recurrences among patients affected by locally advanced stage cancer patients (LACC), undergoing neoadjuvant chemotherapy (NACT) and radical surgery with conservation of ovaries.
Retrospective evaluation of consecutive patients affected by LACC (stage IB2-IIB), treated by NACT followed by radical surgery at National Cancer Institute, Milan, Italy, between 1990-2015.
Overall, 331 patients were included. Stage at presentation included stage IB2, IIA and IIB in 120 (36.3%), 63 (19%) and 148 (44.7%) patients, respectively. Main histotype was squamous cell carcinoma (N.=265, 80.1%) followed by adenocarcinoma/adenosquamous (N.=51, 15.4%), and more than half of patients had a grade 3 carcinoma. Overall, 102 (30.8%) women had at least one ovary preserved during surgery, while 229 (69.2%) had bilateral salpingo-oophorectomy. Comparing patients who had ovarian preservation with patients who had not, we observed that the two groups were comparable in terms of baseline characteristics. Survival outcomes were not influenced by ovarian preservation (disease-free [P=0.93] and overall [P=0.65] survivals). One (1%) woman had a localized ovarian recurrence.
Our data suggest that ovarian preservation at the time of surgery is a safe option among women with LACC after NACT with no detrimental impact on oncologic outcome. Further prospective studies are warranted.
本研究的目的是评估局部晚期癌症患者（LACC）在接受新辅助化疗（NACT）和保留卵巢的根治性手术后发生卵巢转移和复发的比率。
对1990年至2015年间在意大利米兰国家癌症研究所接受NACT后进行根治性手术的连续LACC患者（IB2-IIB期）进行回顾性评估。
总共纳入了331例患者。初诊时的分期分别为IB2期、IIA期和IIB期的患者有120例（36.3%）、63例（19%）和148例（44.7%）。主要组织学类型为鳞状细胞癌（N = 265，80.1%），其次是腺癌/腺鳞癌（N = 51，15.4%），超过一半的患者为3级癌。总体而言，102例（30.8%）女性在手术中至少保留了一侧卵巢，而229例（69.2%）进行了双侧输卵管卵巢切除术。比较保留卵巢的患者和未保留卵巢的患者，我们观察到两组在基线特征方面具有可比性。生存结果不受卵巢保留的影响（无病生存率[P = 0.93]和总生存率[P = 0.65]）。1例（1%）女性发生了局限性卵巢复发。
我们的数据表明，对于接受NACT后的LACC女性，手术时保留卵巢是一种安全的选择，对肿瘤学结局没有不利影响。有必要进行进一步的前瞻性研究。
