Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Japan.
Int J Gynaecol Obstet. 2020 Aug;150(2):177-183. doi: 10.1002/ijgo.13244. Epub 2020 Jul 8.
To investigate the clinical characteristics of women with Stage I primary mucinous epithelial ovarian carcinoma (mEOC) and evaluate the impact of uterus-preserving surgery (UPS) in terms of survival prognosis.
A regional multi-institutional retrospective study conducted between January 1986 and March 2017 by reviewing records of the Tokai Ovarian Tumor Study Group. Clinical and pathologic data and survival outcomes were assessed for women with Stage I primary mEOC. The baseline imbalance between women with and those without UPS was adjusted by an inverse probability of treatment weighting method using the propensity score (PS) of independent clinical variables.
Among 4730 women with malignant ovarian tumors, 185 had Stage I primary mEOC and were included in the study. The mean age was 47.6 years (range 12-87 years), and 56 (30.3%) women underwent UPS. After PS-based adjustment, women in the UPS group did not have a poorer prognosis regarding overall survival (P=0.776) or recurrence-free survival (P=0.683). Even after age stratification, there was no statistical difference in survival outcomes between the UPS and non-UPS groups.
UPS was not associated with decreased survival and may be a treatment option for women with Stage I primary mEOC irrespective of age.
研究Ⅰ期原发性黏液性卵巢上皮癌（mEOC）女性的临床特征，并评估保留子宫手术（UPS）在生存预后方面的影响。
本研究是一项于 1986 年 1 月至 2017 年 3 月间由东海卵巢肿瘤研究组进行的区域多机构回顾性研究，评估了Ⅰ期原发性 mEOC 女性的临床和病理数据及生存结局。采用倾向评分（PS）对 UPS 组与非 UPS 组之间的独立临床变量进行逆概率治疗加权（IPTW）调整，以校正基线不平衡。
在 4730 例患有恶性卵巢肿瘤的女性中，185 例患有Ⅰ期原发性 mEOC 并纳入研究。患者的平均年龄为 47.6 岁（范围 12-87 岁），56 例（30.3%）女性接受了 UPS。经过 PS 校正后，UPS 组的总生存（P=0.776）或无复发生存（P=0.683）预后均未见明显变差。即使进行年龄分层后，UPS 组和非 UPS 组的生存结局也无统计学差异。
UPS 并不与生存预后降低相关，对于Ⅰ期原发性 mEOC 患者，不论年龄大小，UPS 都可能是一种治疗选择。
