铂敏感复发性卵巢癌二线新辅助化疗的价值：基于 GOG-0213 试验的病例对照研究。
The value of secondary neoadjuvant chemotherapy in platinum-sensitive recurrent ovarian cancer: a case-control study post GOG-0213 trial.
机构信息
Department of Gynecologic Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, 210009, Jiangsu, P.R. China.
Nanjing Gaochun People's Hospital, Nanjing, 211300, Jiangsu, P.R. China.
出版信息
J Ovarian Res. 2020 Jun 16;13(1):70. doi: 10.1186/s13048-020-00673-0.
BACKGROUND
The prognostic value and optimal resection outcome related factors of the secondary cytoreduction surgery (SCR) in Platinum-sensitive recurrent ovarian cancer (PSOC) patients were still in doubt. The present retrospective study aims to determine the relationship between the objective response of secondary neo-adjuvant chemotherapy (SNAC) and the resection outcome of SCR.
METHODS
Data were reviewed from 142 type II PSOCs who underwent SCR in Jiangsu Institute of Cancer Research between 1996 and 2016. Among them, 55 cases received preliminary Platinum based SNAC before SCR. Logistic regression analysis was used to explore optimal SCR related factors. Cox proportional hazards model and log-rank test were used to assess the associations between the survival durations and covariates.
RESULTS
Optimal initial CRS (p = 0.02), disappearance of ascites after SNAC (p = 0.04) recurrent status (p = 0.02) and longer Platinum-free interval (p = 0.01) were the independent indicators of optimal SCR. Optimal SCR was associated with time to progression (TTP) but not overall survival (OS) (p = 0.04 and p = 0.41). The TTP and OS of PSOCs underwent SNAC were similar to those patients underwent SCR (p = 0.71, and p = 0.77, respectively) directly.
CONCLUSIONS
SNAC might be another choice for PSOCs were not suitable for directly SCR. Optimal SCR had survival benefit in PSOCs whenever underwent SNAC or not.
背景
铂类敏感复发性卵巢癌（PSOC）患者行二次细胞减灭术（SCR）的预后价值和最佳切除结果相关因素仍存在争议。本回顾性研究旨在确定二次新辅助化疗（SNAC）的客观反应与 SCR 切除结果之间的关系。
方法
回顾性分析 1996 年至 2016 年在江苏省肿瘤研究所接受 SCR 的 142 例 II 型 PSOC 患者的数据。其中，55 例患者在 SCR 前接受初步铂类 SNAC。采用逻辑回归分析探讨最佳 SCR 相关因素。采用 Cox 比例风险模型和对数秩检验评估生存时间与协变量之间的关系。
结果
最佳初始完全缓解率（CRS）（p=0.02）、SNAC 后腹水消失（p=0.04）、复发状态（p=0.02）和无铂间隔时间较长（p=0.01）是最佳 SCR 的独立指标。最佳 SCR 与无进展生存期（TTP）相关，但与总生存期（OS）无关（p=0.04 和 p=0.41）。接受 SNAC 的 PSOCs 的 TTP 和 OS 与直接接受 SCR 的患者相似（p=0.71 和 p=0.77）。
结论
SNAC 可能是不适合直接 SCR 的 PSOCs 的另一种选择。无论是否接受 SNAC，最佳 SCR 均可使 PSOCs 获益。
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