Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Arch Gynecol Obstet. 2021 Dec;304(6):1569-1576. doi: 10.1007/s00404-021-06096-6. Epub 2021 May 23.
To compare clinical characteristics, surgical and oncologic outcomes of clear cell ovarian cancer among patients with cancer arising from endometriosis, cancer coexisting with endometriosis, and cancer without endometriosis.
A retrospective chart review of patients diagnosed with clear cell ovarian cancer during January 1998-March 2013 was performed. All histopathology specimens were reviewed by a gynecologic pathologist and classified into one of the three following endometriosis status groups: arising group, coexisting group, or without group. The primary outcome was disease-specific survival (DSS). The secondary outcomes were progression-free survival, surgical morbidities, response rate, recurrence rate, and cancer-specific death.
Finally, 249 patients were included. There were 82, 96, and 71 patients in the arising, coexisting, and without groups, respectively. Regarding baseline characteristics among groups, the without group was significantly older and had more advanced diseases. There was a significant difference in progression-free survival between the arising group and the without group (p = 0.003). Five-year progression-free survival rates were 62.8% in the arising group, 50.2% in the coexisting group, and 38.3% in the without group. DSS was not significantly different among groups. Multivariate analysis revealed ovarian surface invasion (HR = 2.76) and pelvic lymphadenectomy (HR = 0.39) to be independent prognostic factors for progression-free survival, whereas no remission after primary treatment (HR = 8.03) and pelvic lymphadenectomy (HR = 0.21) were prognostic factors for DSS. Intraoperative blood loss and residual tumor were significantly higher in the without group.
Endometriosis status was found not to significantly influence surgical and oncologic outcomes in patients with clear cell ovarian cancer.
比较源于子宫内膜异位症、合并子宫内膜异位症和无子宫内膜异位症的 clear cell 卵巢癌患者的临床特征、手术和肿瘤学结局。
对 1998 年 1 月至 2013 年 3 月期间诊断为 clear cell 卵巢癌的患者进行回顾性图表审查。所有组织病理学标本均由妇科病理学家进行审查，并分为以下三种子宫内膜异位症状态组之一：发生组、共存组或无组。主要结局是疾病特异性生存（DSS）。次要结局是无进展生存期、手术并发症、缓解率、复发率和癌症特异性死亡率。
最终纳入 249 例患者。发生组、共存组和无组分别有 82、96 和 71 例患者。关于组间基线特征，无组年龄明显较大，疾病进展更为严重。发生组和无组之间无进展生存期存在显著差异（p=0.003）。发生组的 5 年无进展生存率为 62.8%，共存组为 50.2%，无组为 38.3%。各组间 DSS 无显著差异。多因素分析显示卵巢表面侵犯（HR=2.76）和盆腔淋巴结切除术（HR=0.39）是无进展生存期的独立预后因素，而初次治疗后无缓解（HR=8.03）和盆腔淋巴结切除术（HR=0.21）是 DSS 的预后因素。术中出血量和残留肿瘤在无组中明显更高。
在 clear cell 卵巢癌患者中，子宫内膜异位症状态对手术和肿瘤学结局没有显著影响。
