Department of Gynaecological Oncology, Guy's and St Thomas' Hospital NHS Foundation Trust (GSTT), Westminster Bridge Road, London SE1 7EH, United Kingdom of Great Britain and Northern Ireland.
Department of Pathology, Guy's and St Thomas' Hospital NHS Foundation Trust (GSTT), Westminster Bridge Road, London SE1 7EH, United Kingdom of Great Britain and Northern Ireland.
Gynecol Oncol. 2018 Nov;151(2):264-268. doi: 10.1016/j.ygyno.2018.08.042. Epub 2018 Sep 6.
Primary objective of this study was to determine prognostic significance of Bohm's histopathological regression score in patients who received neoadjuvant chemotherapy (NACT) for treatment of high grade serous (HGS) tubal & ovarian carcinoma.
This was a retrospective cohort study of patients who received NACT between 2010 and 2015. The 3 point histopathological regression score of Böhm was used to classify chemotherapy response. Survival outcomes between the 3 different subgroups was analysed and compared with standard clinico-pathological variables using the Cox proportional hazards model and log-rank test.
Study cohort comprised 111 patients. Chemotherapy response score (CRS) 3 was observed in 47 (42.4%) and CRS 1and CRS 2 in 22 (19.8%) and 42 (37.8%) women respectively. Women with CRS score of 1 and 2 combined showed a three-fold increased risk of progression on both univariate and multivariate assessment (HR 3.54; C.I 2.19-5.72, p < 0.001). The median overall survival for patients with CRS 1 was 34 months, CRS 2 was 30 months and 47 months for CRS 3. CRS 1 and 2 combined was the only variable that held significance in prediction of reduced overall survival on multivariate assessment (HR 3.26, C.I 1.91-5.54, p 0.0006). CRS 1 and 2 were also associated with 5.15-fold increased risk of relapse within 6 months of completion of chemotherapy (Odds ratio OR 5.15, C.I 0.07-0.47, p - 0.002).
CRS is an independent prognosticator of survival and reliable predictor of relapse within 6 months in advanced high grade serous tubal and ovarian carcinoma patients receiving NACT.
本研究的主要目的是确定接受新辅助化疗（NACT）治疗高级别浆液性（HGS）输卵管和卵巢癌患者中 Bohm 组织病理学消退评分的预后意义。
这是一项回顾性队列研究，纳入了 2010 年至 2015 年间接受 NACT 的患者。使用 Böhm 的 3 分组织病理学消退评分来对化疗反应进行分类。使用 Cox 比例风险模型和对数秩检验，对 3 个不同亚组之间的生存结果进行分析和比较，并与标准临床病理变量进行比较。
研究队列包括 111 例患者。47 例（42.4%）为化疗反应评分（CRS）3，22 例（19.8%）和 42 例（37.8%）为 CRS 1 和 CRS 2。CRS 评分 1 和 2 的女性在单因素和多因素评估中均显示出进展风险增加三倍（HR 3.54；95%CI 2.19-5.72，p<0.001）。CRS 评分 1 的患者中位总生存期为 34 个月，CRS 2 为 30 个月，CRS 3 为 47 个月。CRS 1 和 2 联合是唯一在多因素评估中对总生存期预测有意义的变量（HR 3.26，95%CI 1.91-5.54，p<0.0006）。CRS 1 和 2 也与化疗完成后 6 个月内复发风险增加 5.15 倍相关（优势比 OR 5.15，95%CI 0.07-0.47，p=-0.002）。
CRS 是接受 NACT 的晚期高级别浆液性输卵管和卵巢癌患者生存的独立预后因素，也是 6 个月内复发的可靠预测因子。
