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低级别浆液性卵巢癌患者行细胞减灭术对生存的影响:土耳其妇科肿瘤学会(TRSGO-OvCa-001)的多中心研究。

Impact of cytoreductive surgery on survival of patients with low-grade serous ovarian carcinoma: A multicentric study of Turkish Society of Gynecologic Oncology (TRSGO-OvCa-001).

机构信息

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey.

出版信息

J Surg Oncol. 2021 May;123(8):1801-1810. doi: 10.1002/jso.26450. Epub 2021 Mar 3.

Abstract

BACKGROUND AND OBJECTIVES

The aim of this study was to analyze the factors affecting recurrence-free (RFS) and overall survival (OS) rates of women diagnosed with low-grade serous ovarian cancer (LGSOC).

METHODS

Databases from 13 participating centers in Turkey were searched retrospectively for women who had been treated for stage I-IV LGSOC between 1997 and 2018.

RESULTS

Overall 191 eligible women were included. The median age at diagnosis was 49 years (range, 21-84 years). One hundred seventy-five (92%) patients underwent primary cytoreductive surgery. Complete and optimal cytoreduction was achieved in 148 (77.5%) and 33 (17.3%) patients, respectively. The median follow-up period was 44 months (range, 2-208 months). Multivariate analysis showed the presence of endometriosis (p = .012), lymphovascular space invasion (LVSI) (p = .022), any residual disease (p = .023), and the International Federation of Gynecology and Obstetrics (FIGO) stage II-IV disease (p = .045) were negatively correlated with RFS while the only presence of residual disease (p = .002) and FIGO stage II-IV disease (p = .003) significantly decreased OS.

CONCLUSIONS

The maximal surgical effort is warranted for complete cytoreduction as achieving no residual disease is the single most important variable affecting the survival of patients with LGSOC. The prognostic role of LVSI and endometriosis should be evaluated by further studies as both of these parameters significantly affected RFS.

摘要

背景与目的

本研究旨在分析影响低级别浆液性卵巢癌(LGSOC)女性无复发生存(RFS)和总生存(OS)率的因素。

方法

回顾性检索土耳其 13 个参与中心的数据库,以寻找 1997 年至 2018 年间接受 I-IV 期 LGSOC 治疗的女性患者。

结果

共纳入 191 名符合条件的女性患者。诊断时的中位年龄为 49 岁(范围 21-84 岁)。175 名(92%)患者接受了初次细胞减灭术。148 名(77.5%)和 33 名(17.3%)患者分别达到了完全和最佳的细胞减灭程度。中位随访时间为 44 个月(范围 2-208 个月)。多因素分析显示,存在子宫内膜异位症(p=0.012)、淋巴血管间隙浸润(LVSI)(p=0.022)、任何残留疾病(p=0.023)和国际妇产科联合会(FIGO)分期 II-IV 期疾病(p=0.045)与 RFS 呈负相关,而仅存在残留疾病(p=0.002)和 FIGO 分期 II-IV 期疾病(p=0.003)显著降低了 OS。

结论

需要进行最大的手术努力以实现完全细胞减灭,因为无残留疾病是影响 LGSOC 患者生存的唯一最重要的变量。LVSI 和子宫内膜异位症的预后作用应通过进一步的研究来评估,因为这两个参数都显著影响 RFS。

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