Bogani Giorgio, Ditto Antonino, Leone Roberti Maggiore Umberto, Scaffa Cono, Mosca Lavinia, Chiappa Valentina, Martinelli Fabio, Lorusso Domenica, Raspagliesi Francesco
Gynecologic Oncology, Fondazione IRCCS Istituto Tumori di Milano, Milan, Italy.
Tumori. 2019 Feb;105(1):92-97. doi: 10.1177/0300891618784785. Epub 2018 Jul 9.
: To test the safety and effectiveness of neoadjuvant chemotherapy followed by interval debulking surgery in unresectable stage IVB serous endometrial cancer.
: Data of consecutive stage IVB serous endometrial cancer are reviewed. Patients undergoing neoadjuvant chemotherapy plus interval debulking surgery were propensity matched with patients undergoing primary surgery followed by adjuvant treatment.
: Thirty-four patients were diagnosed with a stage IVB endometrial cancer. Fifteen (44.1%) patients had neoadjuvant chemotherapy followed by interval debulking surgery; while 19 (55.8%) patients had primary cytoreduction. Among this latter group, 15 (78.9%) patients were selected, using a propensity-matched algorithm. Results of propensity-matching baseline characteristics of patients included were similar between groups. Patients having neoadjuvant chemotherapy plus interval debulking surgery had shorter length of hospital stay (4 [1.40] vs 6 [2.5] days; p=0.011) compared with patients in the control group. Moreover, patients in the neoadjuvant chemotherapy group experienced a trend toward shorter operative time (127 [62] vs 177.6 [84.5] minutes; p=0.072) and lower transfusion rate than patients in the control group (6.6% vs 33.3%; p=0.067). Cytoreduction rate was similar between groups (p=0.962). No difference in postoperative morbidity was recorded. Median disease-free survival was 12.0 vs 15.3 months in the experimental vs control group (p=0.663; log-rank test). Median overall survival was 16.7 vs 18.0 months in the experimental vs control group (p=0.349; log-rank test).
: Neoadjuvant chemotherapy might be a valuable treatment modality for patients with unresectable stage IVB serous endometrial cancer. Innovative treatments are warranted in this cluster of patients.
检测新辅助化疗后行间隔减瘤手术在不可切除的IVB期浆液性子宫内膜癌中的安全性和有效性。
回顾连续性IVB期浆液性子宫内膜癌患者的数据。接受新辅助化疗加间隔减瘤手术的患者与接受初次手术加辅助治疗的患者进行倾向匹配。
34例患者被诊断为IVB期子宫内膜癌。15例（44.1%）患者接受新辅助化疗后行间隔减瘤手术；19例（55.8%）患者接受初次肿瘤细胞减灭术。在后一组中，采用倾向匹配算法选择了15例（78.9%）患者。两组患者倾向匹配后的基线特征结果相似。与对照组患者相比，接受新辅助化疗加间隔减瘤手术的患者住院时间更短（4[1.40]天对6[2.5]天；p=0.011）。此外，新辅助化疗组患者的手术时间有缩短趋势（127[62]分钟对177.6[84.5]分钟；p=0.072），输血率低于对照组（6.6%对33.3%；p=0.067）。两组的肿瘤细胞减灭率相似（p=0.962）。术后发病率无差异。试验组与对照组的无病生存期中位数分别为12.0个月和15.3个月（p=0.663；对数秩检验）。试验组与对照组的总生存期中位数分别为16.7个月和18.0个月（p=0.349；对数秩检验）。
新辅助化疗可能是不可切除的IVB期浆液性子宫内膜癌患者的一种有价值的治疗方式。对于这类患者，有必要采用创新治疗方法。
