Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Gynecol Oncol. 2019 Mar;30(2):e19. doi: 10.3802/jgo.2019.30.e19. Epub 2018 Nov 12.
To investigate the role of adjuvant chemotherapy (CT) in the management of ovarian non-granulosa cell (GC) sex cord-stromal tumors (SCSTs).
The National Cancer Database was accessed and patients diagnosed between 2004 and 2013 with a malignant non-GC SCST were selected. Overall survival (OS) was evaluated with Kaplan-Meier curves and compared with the log-rank test. Multivariate survival analysis was performed with Cox regression. Factors associated with the administration of CT were evaluated with the chi-square test and binary logistic regression.
A total of 391 patients were identified. The majority had a Sertoli-Leydig cell tumor (SLCT) (73.2%) and early stage disease (84.8%). A total of 203 (51.9%) patients received CT. Advanced disease stage, younger age, high-grade histology, White race, large tumor size and SLCT histology were associated with administration of CT. For patients with early stage disease, there was no difference in OS between those who did (n=134) and did not receive CT (n=157), p=0.40; 5-year OS rates were 81.7% and 84.6%, respectively. No mortality benefit was observed (hazard ratio=0.73; 95% confidence interval=0.38-1.4) after controlling for tumor histology. Median OS of women with advanced stage disease who received CT (n=41) was 34.96 months compared to 15.51 months for those who did not (n=11), p=0.013.
Adjuvant CT was associated with improved survival for patients with advanced stage non-GC SCSTs. No clear benefit was found for those with early stage disease.
探讨辅助化疗（CT）在卵巢非颗粒细胞（GC）性索-间质肿瘤（SCST）治疗中的作用。
检索国家癌症数据库，选择 2004 年至 2013 年间诊断为恶性非 GC SCST 的患者。采用 Kaplan-Meier 曲线评估总生存期（OS），并采用对数秩检验进行比较。采用 Cox 回归进行多变量生存分析。采用卡方检验和二元逻辑回归评估与 CT 给药相关的因素。
共纳入 391 例患者。大多数患者为 Sertoli-Leydig 细胞瘤（SLCT）（73.2%）和早期疾病（84.8%）。共有 203 例（51.9%）患者接受 CT 治疗。晚期疾病分期、年龄较小、高级别组织学、白种人、较大肿瘤大小和 SLCT 组织学与 CT 给药相关。对于早期疾病患者，接受 CT（n=134）和未接受 CT（n=157）治疗的患者之间的 OS 无差异（p=0.40）；5 年 OS 率分别为 81.7%和 84.6%。在控制肿瘤组织学后，未观察到死亡率获益（风险比=0.73；95%置信区间=0.38-1.4）。接受 CT（n=41）治疗的晚期疾病患者的中位 OS 为 34.96 个月，而未接受 CT（n=11）的患者为 15.51 个月（p=0.013）。
辅助 CT 与晚期非 GC SCST 患者的生存改善相关。早期疾病患者未发现明显获益。
