Wang Jing, Shi Yuying, Liu Yan, Li Wei, Jiang Hong, Cai Hongbing
Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, People's Republic of China.
Department of Obstetrics and Gynecology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People's Republic of China.
Cancer Manag Res. 2020 Nov 13;12:11631-11638. doi: 10.2147/CMAR.S280141. eCollection 2020.
To provide a reference for clinicians, whether patients with advanced ovarian clear cell carcinoma (OCCC) require chemotherapy (CT) for more than 6 cycles after tumor debulking.
A retrospective review was performed on 85 women diagnosed and treated for advanced OCCC. Outcomes of patients who underwent >6 vs ≤6 cycles of CT were analyzed based on clinicopathological factors.
Among the 85 patients with advanced OCCC, 47 patients underwent ≤6 cycles of CT, and 38 patients underwent CT for over 6 cycles. Out of these, 49 patients had disease recurrence, and 35 died. The 2-year progression-free survival (PFS) for patients in the two groups was 51.5% and 42.2% (P＞0.05), respectively. The 2-year overall survival (OS) was 59.7% and 64.5%, respectively (P＞0.05), and the difference was not statistically significant. Multivariate analysis showed that residual tumor diameter was an independent risk factor for prognosis (PFS and OS). We divided the patients into three groups according to residual tumor diameter as 0 (R0), ≤1cm (R1), and >1cm (R2). The prognosis of R0 was better than R1 and R2. Further studies found that patients who received postoperative adjuvant chemotherapy for over 6 cycles showed no difference in improved prognosis, regardless of residual tumor diameter.
Patients with advanced OCCC who received more than 6 courses of adjuvant chemotherapy after surgery did not show improved prognosis. The residual tumor diameter is an independent indicator of prognosis in patients with advanced OCCC. Complete staging improves the prognosis of patients compared to the ideal or non-ideal cytoreductive surgery.
为临床医生提供参考，以判断晚期卵巢透明细胞癌（OCCC）患者在肿瘤减灭术后是否需要接受超过6个周期的化疗（CT）。
对85例诊断并接受治疗的晚期OCCC女性患者进行回顾性研究。根据临床病理因素分析接受>6个周期与≤6个周期CT治疗患者的结局。
85例晚期OCCC患者中，47例接受≤6个周期CT治疗，38例接受超过6个周期CT治疗。其中，49例疾病复发，35例死亡。两组患者的2年无进展生存期（PFS）分别为51.5%和42.2%（P＞0.05）。2年总生存期（OS）分别为59.7%和64.5%（P＞0.05），差异无统计学意义。多因素分析显示，残留肿瘤直径是预后（PFS和OS）的独立危险因素。我们根据残留肿瘤直径将患者分为三组，分别为0（R0）、≤1cm（R1）和>1cm（R2）。R0组的预后优于R1组和R2组。进一步研究发现，无论残留肿瘤直径如何，接受术后辅助化疗超过6个周期的患者在改善预后方面无差异。
晚期OCCC患者术后接受超过6个疗程辅助化疗并未显示出预后改善。残留肿瘤直径是晚期OCCC患者预后的独立指标。与理想或非理想的细胞减灭术相比，完全分期可改善患者预后。
