Department of Obstetrics Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB; Division of Gynecologic Oncology, CancerCare Manitoba, Winnipeg, MB.
Department of Epidemiology, CancerCare Manitoba, Winnipeg, MB.
J Obstet Gynaecol Can. 2020 Oct;42(10):1217-1222. doi: 10.1016/j.jogc.2020.04.008. Epub 2020 Apr 28.
To describe the response rate to chemotherapy, rates of recurrence, and overall survival in patients with non-serous epithelial ovarian cancers.
This retrospective cohort study used the Manitoba Cancer Registry to identify all women with non-serous epithelial ovarian, fallopian, or peritoneal cancer treated between 1995 and 2010. Chart review entailed extracting information regarding therapy and outcomes. All patients with recurrence were identified and response to chemotherapy was assessed.
We identified 392 patients with non-serous ovarian cancers, 192 of whom received chemotherapy in the first-line setting. Optimal debulking resulted in improvements in rates of recurrence and overall survival (P < 0.001). Histology did not have an effect on recurrence or overall survival. Forty-eight patients (25%) had a recurrence and received second-line therapy, and 21 (11%) received third-line therapy. Response rates were similar regardless of histology. In the second-line setting, 40.9%-83.3% of patients (other > mucinous > clear cell > endometrioid) and in the third-line setting, 33.3%-75.0% of patients (other > mucinous > clear cell > endometrioid) received >6 lines of chemotherapy. Twenty-three percent of patients experienced a recurrence within 2 years of first-line therapy. Two-year survival was 79.4% after first-line treatment, 27.6% after second-line treatment, and 19.5% after third-line treatment.
Patients with clear cell ovarian cancer had chemotherapy continuation rates similar to those of previously reported studies. This is one of the first studies reporting response rates for mucinous and endometrioid subtypes. Recurrent disease responds to treatment with second- and third-line therapy, emphasizing the importance of offering patients subsequent lines of chemotherapy for disease management. Further studies are needed to determine the optimal regimen.
描述非浆液性上皮性卵巢癌患者的化疗缓解率、复发率和总生存率。
本回顾性队列研究使用曼尼托巴癌症登记处确定了 1995 年至 2010 年间治疗的所有非浆液性上皮性卵巢、输卵管或腹膜癌女性患者。图表审查包括提取有关治疗和结果的信息。所有复发患者均被识别，并评估了对化疗的反应。
我们确定了 392 名非浆液性卵巢癌患者，其中 192 名在一线治疗中接受了化疗。最佳减瘤术可提高复发率和总生存率（P < 0.001）。组织学对复发或总生存率没有影响。48 名患者（25%）出现复发并接受二线治疗，21 名患者（11%）接受三线治疗。无论组织学如何，反应率相似。在二线治疗中，40.9%-83.3%的患者（其他>黏液性>透明细胞>子宫内膜样）和三线治疗中，33.3%-75.0%的患者（其他>黏液性>透明细胞>子宫内膜样）接受>6 线化疗。23%的患者在一线治疗后 2 年内复发。一线治疗后 2 年生存率为 79.4%，二线治疗后为 27.6%，三线治疗后为 19.5%。
透明细胞卵巢癌患者的化疗延续率与先前报道的研究相似。这是首次报告黏液性和子宫内膜样亚型的反应率的研究之一。复发性疾病对二线和三线治疗有反应，强调为患者提供后续化疗线以进行疾病管理的重要性。需要进一步研究以确定最佳方案。
