Montavon Sartorius Céline, Mirza Uzma, Schötzau Andreas, Mackay Gillian, Fink Daniel, Hacker Neville F, Heinzelmann-Schwarz Viola
Department of Gynecology and Gynecological Oncology, Hospital for Women, University Hospital Basel, Basel, Switzerland,
Ovarian Cancer Research, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Cancer Manag Res. 2018 Oct 17;10:4709-4718. doi: 10.2147/CMAR.S174777. eCollection 2018.
The stage of disease is one of the strongest prognostic factors in epithelial ovarian cancer. The International Federation of Gynecology and Obstetrics (FIGO) classification was revised in 2013; stage IC was subdivided into IC1 (intraoperative surgical spill), IC2 (capsule rupture before surgery or tumor on surface), and IC3 (positive peritoneal washing or ascites). Our aim was to compare the outcome of patients in the new FIGO stage I subgroups, as this might influence adjuvant therapy decisions.
Patient databases of three gynecological oncology centers were retrospectively analyzed. Patients with FIGO stage I ovarian cancers were restaged according to the revised classification, based on operative and pathological reports, and determined patient outcomes.
We analyzed 128 patients with ovarian cancers. In FIGO IA, we found 11.3% recurrences and 4.2% deaths. In FIGO IC, 21.8% of the patients recurred and 7.3% died. There was a trend toward a shorter time to recurrence when comparing IA to IC (=0.076). Within all new subgroups of FIGO IC, there was no difference in time to recurrence (=0.59). There was also no significant difference in survival when FIGO IA was compared to FIGO IC in comparison with the new individual classifications (IA to IC, IA to IC1, 2, or 3; =0.60, =0.15, =0.61, =0.66, respectively) or within the different subgroups (=0.56). Platinum-based chemotherapy was given to the majority (82.6%, n=38/46) of the FIGO IC patients compared to 30.9% in FIGO IA (n=17/55). There was no significant difference within the new subgroups of FIGO IC (=0.88).
In our retrospective analysis, the new FIGO staging of IC ovarian cancers did not predict prognosis, but the use of adjuvant chemotherapy in 82.6% of the stage IC patients may have biased the outcome.
疾病分期是上皮性卵巢癌最强的预后因素之一。国际妇产科联盟（FIGO）分类于2013年进行了修订；IC期被细分为IC1（术中手术播散）、IC2（手术前包膜破裂或表面有肿瘤）和IC3（腹水或腹腔冲洗液阳性）。我们的目的是比较新的FIGO I期亚组患者的结局，因为这可能会影响辅助治疗决策。
对三个妇科肿瘤中心的患者数据库进行回顾性分析。根据修订后的分类，基于手术和病理报告对FIGO I期卵巢癌患者重新分期，并确定患者结局。
我们分析了128例卵巢癌患者。在FIGO IA期，我们发现复发率为11.3%，死亡率为4.2%。在FIGO IC期，21.8%的患者复发，7.3%的患者死亡。比较IA期和IC期时，有复发时间缩短的趋势（=0.076）。在FIGO IC期的所有新亚组中，复发时间没有差异（=0.59）。与新的个体分类（IA期与IC期、IA期与IC1期、2期或3期；分别为=0.60、=0.15、=0.61、=0.66）相比，或在不同亚组内（=0.56），比较FIGO IA期和FIGO IC期时，生存率也没有显著差异。与FIGO IA期的30.9%（n = 17/55）相比，大多数（82.6%，n = 38/46）FIGO IC期患者接受了铂类化疗。在FIGO IC期的新亚组中没有显著差异（=0.88）。
在我们的回顾性分析中，FIGO对IC期卵巢癌的新分期不能预测预后，但82.6%的IC期患者使用辅助化疗可能使结局产生了偏差。
