Quan Quan, Zhou Shuwei, Liu Yao, Yin Wanchun, Liao Qianqian, Ren Siling, Zhang Fenfen, Meng Yu, Mu Xiaoling
Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Obstetrics, Chongqing Health Center for Women and Children, Chongqing, China.
J Obstet Gynaecol Res. 2021 Apr;47(4):1527-1535. doi: 10.1111/jog.14682. Epub 2021 Jan 27.
Ascites is a tumor microenvironment, ascites and massive ascites-induce compression could promote the progression of epithelial ovarian cancer (EOC); however, the impact of ascites volume on clinical outcomes has not been studied extensively. We aimed to investigate the association between ascites volume and clinical outcomes especially platinum resistance in EOC.
We retrospectively evaluated a total of 546 EOC patients with respect to the amount of ascites, clinicopathologic factors, and survival. Using the threshold of 1500 ml to classify patients into small- and large-volume ascites groups, we analyzed the correlation between ascites volume and clinicopathological factors, including platinum-free interval (PFI), and prognosis.
Patients with large volume ascites were more likely to present with later stage disease, primary platinum-resistant (PPR) cancer, and suboptimal cytoreduction. Prolonged PFI was associated with decreased ascites volume. The large-volume ascites group showed worse progression-free survival (PFS) and overall survival (OS). An increase in ascites volume was associated with an increased risk of disease recurrence (hazard ratio [HR] = 1.115, 95% confidence interval [CI]: 1.035-1.200) and death (HR = 1.213, 95% CI: 1.090-1.350).
Ascites was an independent predictor of PFS and OS in EOC patients. A large volume of ascites predicated a shortened PFI, an increased incidence of PPR and suboptimal cytoreduction. Thus, the volume of ascites is a simply available clinical parameter, which could be used to evaluate the prognosis and platinum resistance of EOC patients early, it contributes to formulate individualized treatment plan and improve the outcome of EOC patients.
腹水是一种肿瘤微环境，腹水及大量腹水所致压迫可促进上皮性卵巢癌（EOC）进展；然而，腹水量对临床结局的影响尚未得到广泛研究。我们旨在探讨腹水量与EOC临床结局尤其是铂耐药之间的关联。
我们回顾性评估了总共546例EOC患者的腹水量、临床病理因素及生存情况。以1500 ml为界将患者分为少量腹水组和大量腹水组，分析腹水量与包括无铂间期（PFI）在内的临床病理因素及预后之间的相关性。
大量腹水患者更易出现晚期疾病、原发性铂耐药（PPR）癌及减瘤不彻底。PFI延长与腹水量减少相关。大量腹水组的无进展生存期（PFS）和总生存期（OS）较差。腹水量增加与疾病复发风险增加（风险比[HR]=1.115，95%置信区间[CI]：1.035 - 1.200）及死亡风险增加（HR = 1.213，95% CI：1.090 - 1.350）相关。
腹水是EOC患者PFS和OS的独立预测因素。大量腹水预示PFI缩短、PPR发生率增加及减瘤不彻底。因此，腹水量是一个简单易用的临床参数，可用于早期评估EOC患者的预后和铂耐药情况，有助于制定个体化治疗方案并改善EOC患者的结局。
