Park Soo Jin, Mun Jaehee, Lee Eun Ji, Park Sunwoo, Kim Sang Youn, Lim Whasun, Song Gwonhwa, Kim Jae-Weon, Lee Seungmee, Kim Hee Seung
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.
Institute of Animal Molecular Biotechnology and Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seoul, South Korea.
Front Oncol. 2021 Apr 22;11:673631. doi: 10.3389/fonc.2021.673631. eCollection 2021.
We classified clinical phenotypes based on tumor separability from the rectosigmoid colon and then evaluated the effect of these clinical phenotypes on surgical outcomes and prognosis of advanced ovarian cancer. We collected data of patients with stage IIIB-IVB disease who either underwent visceral segmental serosectomy (VSS) or low anterior resection (LAR) during maximal debulking surgery. All patients were divided into the following, according to the resection types of tumors involving the rectosigmoid colon: the focal (tumor-involved length <18 cm) and separable (FS) group that received VSS, the focal and inseparable (FI) that received LAR, or the diffuse (tumor-involved length ≥18 cm) group (D) that also received LAR. A total of 83 patients were included in FS (n=44, 53%), FI (n=18, 21.7%), and D (n=24, 25.3%) groups. FS and D groups with more extensive tumors were related to wider extent of surgery and more tumor infiltration except for bowels, whereas FI and D groups with more invasive tumors were associated with wider extent of surgery, more tumor infiltration to bowels, longer operation time, more blood loss, more transfusion, longer hospitalization, and higher surgical complexity scores. Moreover, FS and FI groups showed better progression-free survival than D group, whereas FS group demonstrated better overall survival than FI and D groups. Clinical phenotypes based on tumor separability from the rectosigmoid colon may depend on tumor invasiveness and extensiveness in advanced ovarian cancer. Moreover, these clinical phenotypes may affect surgical outcomes and survival.
我们根据肿瘤与直肠乙状结肠的可分离性对临床表型进行分类，然后评估这些临床表型对晚期卵巢癌手术结局和预后的影响。我们收集了在肿瘤细胞减灭术中接受内脏节段性浆膜切除术（VSS）或低位前切除术（LAR）的IIIB-IVB期疾病患者的数据。根据累及直肠乙状结肠的肿瘤切除类型，将所有患者分为以下几组：接受VSS的局灶性（肿瘤累及长度<18 cm）且可分离（FS）组、接受LAR的局灶性且不可分离（FI）组，或同样接受LAR的弥漫性（肿瘤累及长度≥18 cm）组（D）。FS组（n=44，53%）、FI组（n=18，21.7%）和D组（n=24，25.3%）共纳入83例患者。肿瘤范围更广的FS组和D组与手术范围更广及除肠道外更多的肿瘤浸润相关，而肿瘤侵袭性更强的FI组和D组则与手术范围更广、更多的肠道肿瘤浸润、手术时间更长、失血更多、输血更多、住院时间更长及手术复杂程度评分更高相关。此外，FS组和FI组的无进展生存期比D组更好，而FS组的总生存期比FI组和D组更好。基于肿瘤与直肠乙状结肠可分离性的临床表型可能取决于晚期卵巢癌的肿瘤侵袭性和范围。此外，这些临床表型可能会影响手术结局和生存情况。
