Chung Young Shin, Lee Jung Yun, Kim Hyun Soo, Nam Eun Ji, Kim Sang Wun, Kim Young Tae
Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2018 Oct;59(8):930-936. doi: 10.3349/ymj.2018.59.8.930.
Outcomes in patients with ovarian high-grade serous carcinoma (HGSC) treated with neoadjuvant chemotherapy (NAC) have been widely studied; however, there is limited information on responses to chemotherapy among patients with non-HGSC. The aim of this study was to compare the survival outcomes of patients with advanced-stage non-HGSC and HGSC treated with NAC.
This study was a retrospective analysis of patients with advanced-stage ovarian cancer treated at Yonsei Cancer Hospital between 2006 and 2017. The demographics, chemotherapy response, and survival rates were compared between patients with non-HGSC and those with HGSC.
Among 220 patients who underwent NAC, 25 (11.4%) patients had non-HGSC histologic subtypes, and all received a taxane-platinum combination regimen for NAC. Patients with non-HGSC had lower baseline cancer antigen-125 levels (<0.001), poorer response rates (<0.001), lower rates of optimal cytoreduction (=0.003), and poorer progression-free survival (PFS) (median PFS 10.3 months vs. 18.3 months; =0.009) and overall survival (OS) (median OS 25.5 months vs. 60.6 months; <0.001), compared to those with HGSC. In multivariate analysis, non-HGSC was a negative prognostic factor for both PFS [hazard ratio (HR), 3.19; 95% confidence interval (CI), 1.73-5.88] and OS (HR, 4.22; 95% CI, 2.07-8.58).
In this study, poorer survival outcomes were observed in patients who underwent NAC for treatment of non-HGSC versus those treated for HGSC. Different treatment strategies are urgently required to improve survival outcomes for patients with non-HGSC undergoing NAC.
新辅助化疗（NAC）治疗卵巢高级别浆液性癌（HGSC）患者的结局已得到广泛研究；然而，关于非HGSC患者对化疗的反应信息有限。本研究的目的是比较接受NAC治疗的晚期非HGSC和HGSC患者的生存结局。
本研究是对2006年至2017年在延世癌症医院接受治疗的晚期卵巢癌患者的回顾性分析。比较了非HGSC患者和HGSC患者的人口统计学、化疗反应和生存率。
在接受NAC的220例患者中，25例（11.4%）为非HGSC组织学亚型，所有患者均接受了紫杉烷-铂联合方案的NAC治疗。与HGSC患者相比，非HGSC患者的基线癌抗原-125水平较低（<0.001）、反应率较差（<0.001）、最佳细胞减灭率较低（=0.003），无进展生存期（PFS）较差（中位PFS 10.3个月对18.3个月；=0.009）和总生存期（OS）较差（中位OS 25.5个月对60.6个月；<0.001）。在多变量分析中，非HGSC是PFS[风险比（HR），3.19；95%置信区间（CI），1.73-5.88]和OS（HR，4.22；95%CI，2.07-8.58）的负性预后因素。
在本研究中，接受NAC治疗的非HGSC患者的生存结局比HGSC患者更差。迫切需要不同的治疗策略来改善接受NAC治疗的非HGSC患者的生存结局。
