Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
Int J Gynecol Cancer. 2019 Feb;29(2):334-340. doi: 10.1136/ijgc-2018-000058. Epub 2019 Jan 4.
The aim of this study is to analyze the long-term relapse-free survival and overall survival outcomes of primary ovarian cancer patients using adenosine triphosphate-based chemotherapy response analysis.
In total, 162 primary epithelial ovarian cancer patients who underwent chemotherapy response assay for carboplatin, cisplatin, and paclitaxel by adenosine triphosphate-based chemotherapy response analysis prior to chemotherapy between December 2006 and November 2016 were retrospectively reviewed. Chemosensitivity with single or combined three agents and clinical characteristics of patients were studied to understand their correlation with long-term relapse-free survival and overall survival.
Median follow-up time was 61.4 (range 1 - 130) months. Univariate analysis showed the paclitaxel-sensitive group (HR = 0.625, 95%CI = 0.393 to 0.994), combined carboplatin and paclitaxel-sensitive group (HR = 0.574, 95%CI = 0.352 to 0.937), and combined carboplatin, cisplatin, and paclitaxel-sensitive group (HR = 0.489, 95%CI = 0.295 to 0.810) were highly associated with better relapse-free survival than their corresponding non-sensitive groups. The carboplatin-sensitive group (HR = 0.533, 95%CI = 0.303 to 0.939), cisplatin-sensitive group (HR = 0.433. 95%CI = 0.251 to 0.748), and combined carboplatin- and cisplatin-sensitive group (HR = 0.286, 95%CI = 0.142 to 0.576) were highly associated with better overall survival than their corresponding non-sensitive groups. Combined carboplatin, cisplatin, and paclitaxel chemosensitivity, together with International Federation of Gynecology and Obstetrics (FIGO) stage were independent predictors for relapse-free survival. Single or combined chemosensitivity of cisplatin and/or carboplatin, together with residual tumor size and FIGO stage, were significant independent predictors for overall survival on a multivariate hazard model.
Paclitaxel sensitivity is a prognostic factor of long-term relapse-free survival in patients with epithelial ovarian cancer, but platinum sensitivity is a more important prognostic factor for long-term overall survival.
本研究旨在通过基于三磷酸腺苷的化疗反应分析，分析原发性卵巢癌患者的无复发生存和总体生存结果。
回顾性分析了 2006 年 12 月至 2016 年 11 月期间，162 例原发性上皮性卵巢癌患者在化疗前接受基于三磷酸腺苷的化疗反应分析进行顺铂、卡铂和紫杉醇化疗反应检测。研究化疗敏感性单药或联合三种药物及患者的临床特征与无复发生存和总生存的相关性。
中位随访时间为 61.4（1-130）个月。单因素分析显示，紫杉醇敏感组（HR=0.625，95%CI=0.393-0.994）、卡铂联合紫杉醇敏感组（HR=0.574，95%CI=0.352-0.937）和卡铂、顺铂联合紫杉醇敏感组（HR=0.489，95%CI=0.295-0.810）与无复发生存较好的相应非敏感组相比，具有显著相关性。卡铂敏感组（HR=0.533，95%CI=0.303-0.939）、顺铂敏感组（HR=0.433，95%CI=0.251-0.748）和卡铂、顺铂联合敏感组（HR=0.286，95%CI=0.142-0.576）与无复发生存较好的相应非敏感组相比，具有显著相关性。卡铂、顺铂和紫杉醇联合化疗敏感性，以及国际妇产科联合会（FIGO）分期是无复发生存的独立预测因素。单药或联合顺铂和/或卡铂的化疗敏感性，以及残余肿瘤大小和 FIGO 分期是总生存的多变量危险模型的显著独立预测因素。
紫杉醇敏感性是上皮性卵巢癌患者无复发生存的预后因素，但铂类药物敏感性是长期总生存的更重要预后因素。
