Jani Ina, Lastra Ricardo R, Brito Katherine S, Liao Chuanhong, Lazo Isabel, Lee Nita Karnik, Yamada S Diane, Kurnit Katherine C
Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA.
Department of Pathology, University of Chicago, Chicago, Illinois, USA.
Int J Gynecol Cancer. 2021 Jun;31(6):852-858. doi: 10.1136/ijgc-2020-002202. Epub 2021 Apr 8.
Chemotherapy response score (CRS) applied to interval debulking specimens quantifies histopathologic response to neoadjuvant chemotherapy in patients with advanced ovarian carcinoma and correlates with progression-free and overall survival.
To investigate whether the chemotherapy response score could be applied to interval debulking specimens in patients with advanced endometrial carcinoma and be a prognostic indicator.
The study included patients with clinical stage III-IV endometrial carcinoma who received neoadjuvant chemotherapy followed by interval debulking surgery. Chemotherapy response scores were assigned to omental and adnexal metastases, and categorized as no/minimal (CRS1), partial (CRS2), and complete/near-complete (CRS3) response to neoadjuvant chemotherapy. Descriptive statistics were used to evaluate baseline characteristics and feasibility of chemotherapy response score assessment. Univariate analyses were used to evaluate associations between the chemotherapy response score, complete cytoreduction, and survival.
This study included 40 patients. The median age was 63.5 years, and 31 patients (78%) had stage IV disease. Thirty patients had an omentectomy, 22 patients (73%) had an omental chemotherapy response score assigned. Thirty-nine patients had a bilateral salpingo-oophorectomy, 28 patients (72%) had an adnexal chemotherapy response score assigned. Omental CRS2 and CRS3 were associated with improved progression-free survival (CRS2: HR=0.18, p<0.01; CRS3: HR=0.11, p<0.01) and overall survival (CRS2: HR=0.10, p<0.01; CRS3: HR=0.16, p=0.04). Adnexal CRS2 and CRS3 were associated with improved progression-free survival (CRS2: HR=0.23, p<0.01; CRS3: HR=0.20, p=0.03). Chemotherapy response scores were also associated with an increased likelihood of having a complete cytoreduction.
Chemotherapy response score can be applied to omental and adnexal metastases in patients with advanced endometrial carcinoma and was associated with survival and complete cytoreduction. The score may be a prognostic indicator and help to guide first-line treatment of patients with endometrial carcinoma.
应用于中间减瘤标本的化疗反应评分（CRS）可量化晚期卵巢癌患者对新辅助化疗的组织病理学反应，并与无进展生存期和总生存期相关。
探讨化疗反应评分是否可应用于晚期子宫内膜癌患者的中间减瘤标本，并作为一项预后指标。
本研究纳入了临床分期为III-IV期的子宫内膜癌患者，这些患者接受了新辅助化疗，随后进行中间减瘤手术。对大网膜和附件转移灶进行化疗反应评分，并将对新辅助化疗的反应分为无/最小（CRS1）、部分（CRS2）和完全/近乎完全（CRS3）反应。采用描述性统计评估基线特征和化疗反应评分评估的可行性。采用单因素分析评估化疗反应评分、完全细胞减灭术和生存期之间的关联。
本研究纳入了40例患者。中位年龄为63.5岁，31例患者（78%）为IV期疾病。30例患者接受了大网膜切除术，22例患者（73%）获得了大网膜化疗反应评分。39例患者接受了双侧输卵管卵巢切除术，28例患者（72%）获得了附件化疗反应评分。大网膜CRS2和CRS3与无进展生存期改善相关（CRS2：HR=0.18，p<0.01；CRS3：HR=0.11，p<0.01）和总生存期改善相关（CRS2：HR=0.10，p<0.01；CRS3：HR=0.16，p=0.04）。附件CRS2和CRS3与无进展生存期改善相关（CRS2：HR=0.23，p<0.01；CRS3：HR=0.20，p=0.03）。化疗反应评分也与完全细胞减灭术的可能性增加相关。
化疗反应评分可应用于晚期子宫内膜癌患者的大网膜和附件转移灶，且与生存期和完全细胞减灭术相关。该评分可能是一项预后指标，有助于指导子宫内膜癌患者的一线治疗。
