Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Arch Gynecol Obstet. 2021 Oct;304(4):1043-1053. doi: 10.1007/s00404-021-06017-7. Epub 2021 Mar 9.
The aim of the study was to investigate the relative risk factors associated with the prognosis and effective treatments of alpha-fetoprotein (AFP)-producing epithelial ovarian carcinoma (EOC).
We presented three cases of AFP-producing EOC and performed a brief review to summarize the clinicopathological features and prognostic factors of 24 cases that have been previously reported. We evaluated the correlations among prognostic and clinical parameters, such as stage, pathology and chemotherapy regimens. In addition, a retrospective review of these 27 cases was conducted, and survival curves were estimated using the Kaplan-Meier method.
The patients were aged between 23 and 77 years. The median overall survival was 10 months, and ten (37.04%) patients died within 18 months. We compared the overall mean survival times of all patients in different stages, and the results suggest that the postoperative pathological staging is hardly correlated with prognosis (P = 0.76). There was a correlation between pathology and prognosis (P = 0.0018). The mean survival time was longer for patients who had undergone chemotherapy than for those without chemotherapy (14.88 vs 0.65 months) (P < 0.0001). Moreover, although patients had a good response to the regimens for PEB and TC (P = 0.004), there was no significant difference between PEB and TC (P = 0.386).
AFP-producing EOC is uncommon and regarded as an extremely malignant type of tumor. Patients with chemotherapy may have a longer survival time; additionally, PEB and TC may be an optimal selection for this kind of tumor. Further large-scale studies are needed to confirm our findings.
本研究旨在探讨与甲胎蛋白(AFP)产生的上皮性卵巢癌(EOC)预后和有效治疗相关的相对危险因素。
我们报告了 3 例 AFP 产生的 EOC,并进行了简要复习,以总结 24 例先前报道的病例的临床病理特征和预后因素。我们评估了预后和临床参数(如分期、病理和化疗方案)之间的相关性。此外,对这 27 例病例进行了回顾性分析,并使用 Kaplan-Meier 方法估计生存曲线。
患者年龄为 23 至 77 岁。中位总生存期为 10 个月,10 例(37.04%)患者在 18 个月内死亡。我们比较了不同分期患者的总平均生存时间,结果表明术后病理分期与预后相关性不大(P=0.76)。病理与预后之间存在相关性(P=0.0018)。接受化疗的患者平均生存时间长于未接受化疗的患者(14.88 与 0.65 个月)(P<0.0001)。此外,尽管 PEB 和 TC 方案对患者有良好的反应(P=0.004),但 PEB 和 TC 之间无显著差异(P=0.386)。
AFP 产生的 EOC 较为罕见,被认为是一种极其恶性的肿瘤类型。接受化疗的患者可能有更长的生存时间;此外,PEB 和 TC 可能是这种肿瘤的最佳选择。需要进一步的大规模研究来证实我们的发现。