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晚期上皮性卵巢癌中胸膜转移和恶性胸腔积液的预后价值及治疗意义。

Prognostic Value and Therapeutic Implications of Pleural Carcinosis and Malignant Pleural Effusion in Advanced Epithelial Ovarian Cancer.

机构信息

Department of Gynecological Oncology and Tumor Surgery, European Competence Center for Ovarian Cancer, Charité Campus Virchow Clinic, Berlin, Germany.

West London Gynecological Cancer Center, Hammersmith Hospital, Imperial College, London, U.K.

出版信息

Anticancer Res. 2021 Apr;41(4):2033-2038. doi: 10.21873/anticanres.14971.

Abstract

AIM

To demonstrate the prognostic value of pleural carcinosis/effusion in a cohort of patients with advanced epithelial ovarian cancer (EOC) and the associated therapeutic implications.

PATIENTS AND METHODS

Overall, data for 388 patients with EOC with confirmed malignant pleural effusion (MPE) or pleural carcinosis were retrospectively analyzed. Exclusion criteria were non-epithelial ovarian malignancies and presence of other comorbidities associated with pleural effusions.

RESULTS

The prognosis after the occurrence of MPE during the EOC in relapsed cases was poor with an overall survival of 9.9 months. In the multivariate analysis, the time point of the manifestation of the pleural effusion (p<0.001), platinum sensitivity (p=0.003), performance status (p=0.045) and presence of ascites (p=0.004) were significant prognostic factors for overall survival.

CONCLUSION

Even in this less favorable collective, well-established EOC prognostic factors were associated with a significantly better overall survival. This suggests that the overall behavioral pattern of the disease has strong similarities in patients with and without pleural effusion or carcinosis and merits an equally high therapeutic effort.

摘要

目的

在一组晚期上皮性卵巢癌(EOC)患者中,证明胸腔转移/胸腔积液的预后价值,并探讨其相关的治疗意义。

患者和方法

回顾性分析了 388 例经证实患有恶性胸腔积液(MPE)或胸腔转移的 EOC 患者的数据。排除标准为非上皮性卵巢恶性肿瘤和存在与胸腔积液相关的其他合并症。

结果

在复发的 EOC 患者中,MPE 发生后的预后较差,总生存期为 9.9 个月。在多变量分析中,胸腔积液表现的时间点(p<0.001)、铂类药物敏感性(p=0.003)、体能状态(p=0.045)和腹水的存在(p=0.004)是总生存期的显著预后因素。

结论

即使在这个预后较差的患者群体中,已确立的 EOC 预后因素与显著更好的总生存期相关。这表明,在有或没有胸腔积液或转移的患者中,疾病的总体行为模式具有很强的相似性,值得给予同样高的治疗努力。

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