Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
Int J Gynaecol Obstet. 2020 Aug;150(2):169-176. doi: 10.1002/ijgo.13199. Epub 2020 Jun 3.
To evaluate long-term outcomes after surgery for apparent early-stage ovarian cancer (OC).
Retrospective analysis of women who underwent staging surgery for apparent early-stage OC at a single center in Milan, Italy, from 1990 to 2008, and had a follow-up longer than 10 years (living women with no recurrence). Univariate and multivariate analyses and propensity score matching were carried out.
Overall, 182 women underwent radical (n=148, 81.3%) or conservative (n=34, 18.7%) procedures for early-stage OC. Ten-year disease-free and overall survival were 82.9% (n=151) and 87.9% (n=160), respectively. Conservative or radical surgery had similar disease-free (log-rank test, P=0.783) and overall (log-rank test, P=0.783) survival. These data were confirmed after the application of propensity score matching. High-risk features correlated with non-significant worse disease-free survival (P=0.080). In the high-risk group (≥Grade 3 or ≥ Stage IC), type of surgical approach (conservative vs radical) did not affect survival (hazard ratio, 0.81; 95% confidence interval, 0.18-3.56; P=0.781).
Women with early-stage OC had encouraging long-term survival. The presence of high-risk disease had detrimental effects on survival, regardless of surgical approach. High-risk disease should not be considered a contraindication to conservative surgery.
评估行手术治疗的早期卵巢癌（OC）患者的长期预后。
回顾性分析 1990 年至 2008 年在意大利米兰的一家中心行分期手术治疗的早期 OC 患者的临床资料，这些患者随访时间超过 10 年（无复发生存的存活女性）。进行单因素和多因素分析以及倾向评分匹配。
182 例女性接受了早期 OC 的根治性（n=148，81.3%）或保守性（n=34，18.7%）手术。10 年无病生存率和总生存率分别为 82.9%（n=151）和 87.9%（n=160）。保守性或根治性手术的无病生存率（对数秩检验，P=0.783）和总生存率（对数秩检验，P=0.783）相似。在应用倾向评分匹配后，这些数据得到了证实。高危特征与无显著差异的无病生存率相关（P=0.080）。在高危组（≥Grade 3 或≥IC 期）中，手术方式（保守性与根治性）对生存没有影响（风险比，0.81；95%置信区间，0.18-3.56；P=0.781）。
早期 OC 患者的长期生存预后良好。高危疾病的存在对生存有不利影响，而与手术方式无关。高危疾病不应被视为保守手术的禁忌证。
