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早期卵巢癌保守手术后长期结局的 10 年随访研究。

Ten-year follow-up study of long-term outcomes after conservative surgery for early-stage ovarian cancer.

机构信息

Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.

出版信息

Int J Gynaecol Obstet. 2020 Aug;150(2):169-176. doi: 10.1002/ijgo.13199. Epub 2020 Jun 3.

Abstract

OBJECTIVE

To evaluate long-term outcomes after surgery for apparent early-stage ovarian cancer (OC).

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

评估行手术治疗的早期卵巢癌(OC)患者的长期预后。

方法

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。

结果

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)。

结论

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。

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