Xi Sujuan, Li Zaiyi, Guo Quan, Lin Wenjing, Liang Xiaokun, Ma Lin
The Reproductive Medical Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China.
Department of gynaechology, Shengjing Hospital Medical University, Shenyang, China.
J Cancer. 2020 May 18;11(15):4625-4640. doi: 10.7150/jca.44494. eCollection 2020.
: Population-based data on the prognosis of brain metastases at initial diagnosis of ovary cancer (OCBM) are currently lacking. Besides, the effective treatment for OCBM patients is still controversial now. The study aimed to explore the prognostic factors among OCBM. : We retrospectively reviewed the OCBM patients from the Surveillance, Epidemiology, and End Result (SEER) database of the National Cancer Institute to investigate predictors of the presence of OCBM and its' prognostic factors related to all-cause mortality. We employed multivariable logistic and Cox regression analysis. Furthermore, to minimize the impact of potential confounding factors, we conducted a 1:1 propensity score matching (PSM) analysis. : A total of 29,512 cases of OC patients entered into the study, including 89 patients with brain metastases of ovarian cancer, which accounted for 0.30% of the entire cohort and 12.02% of the metastatic disease subset. We identified eight factors, including laterality, histology, surgery, radiotherapy, chemotherapy, and extracranial metastatic sites to bone, liver, and lung, as predictors of OCBM based on multivariable logistic regression among the entire cohort. The median survival time of OCBM was 2.0 months, and the interquartile range was 2.0-10.0 mo. The patients who received comprehensive treatment had better prognosis. Based on the multivariable Cox model, marital status, surgery, chemotherapy, and extensive therapy (including RSC, SC, and RC) were identified as predictors of OS. Besides, a new factor (brain metastasis) was identified by 1:1 PSM -based multiple Cox regression, apart from the above prognostic factors for OS. : This study provided a population-based estimate of the proportion and prognosis for newly diagnosed ovary cancer with brain metastases. These findings may add materials to guidelines for preliminary screening and optimal treatment of OCBM patients.
目前缺乏基于人群的卵巢癌脑转移(OCBM)初诊时预后的数据。此外,OCBM患者的有效治疗目前仍存在争议。本研究旨在探讨OCBM的预后因素。
我们回顾性分析了美国国立癌症研究所监测、流行病学和最终结果(SEER)数据库中的OCBM患者,以研究OCBM存在的预测因素及其与全因死亡率相关的预后因素。我们采用了多变量逻辑回归和Cox回归分析。此外,为了尽量减少潜在混杂因素的影响,我们进行了1:1倾向评分匹配(PSM)分析。
共有29512例OC患者纳入研究,其中89例为卵巢癌脑转移患者,占整个队列的0.30%,占转移性疾病亚组的12.02%。基于整个队列的多变量逻辑回归,我们确定了八个因素,包括病变侧别、组织学类型、手术、放疗、化疗以及骨、肝和肺的颅外转移部位,作为OCBM的预测因素。OCBM的中位生存时间为2.0个月,四分位间距为2.0 - 10.0个月。接受综合治疗的患者预后较好。基于多变量Cox模型,婚姻状况、手术、化疗和广泛治疗(包括RSC、SC和RC)被确定为总生存期(OS)的预测因素。此外,除了上述OS的预后因素外,通过基于1:1 PSM的多变量Cox回归还确定了一个新因素(脑转移)。
本研究提供了基于人群的新诊断卵巢癌脑转移比例和预后的估计。这些发现可能为OCBM患者的初步筛查和最佳治疗指南增添内容。