子宫内膜样卵巢癌患者手术后的临床结局。
Clinical outcomes of patients with endometrioid epithelial ovarian cancer following surgical treatment.
机构信息
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
出版信息
J Surg Oncol. 2021 Oct;124(5):846-851. doi: 10.1002/jso.26597. Epub 2021 Jul 16.
BACKGROUND
Endometrioid epithelial ovarian cancer (EEOC) is rare, and its management poorly defined. We examined factors associated with 5-year progression-free survival (PFS) after surgery for EEOC.
METHODS
Retrospective study: treatment and outcomes of all EEOC patients undergoing initial surgery at, or presenting to, our institution within 3 months of initial surgery, 1/2002-9/2017.
RESULTS
In total, 212 patients were identified. Median follow-up, 63.9 months (range, 0.7-192); median age at diagnosis, 52 years (range, 20-88); disease stage: I, n = 145 (68%); II, n = 47 (22%); III/IV, n = 20 (9%); FIGO grade: 1, 127 (60%); 2, 66 (31%); 3, 17 (8%); unknown, 2 (1%). One hundred twenty-eight (60%) had endometriosis; 75 (35%), synchronous endometrioid endometrial cancer (80%, IA); 101 (48%), complete surgical staging; 8 (5%), positive pelvic lymph nodes (LNs); 6 (4%), positive para-aortic LNs; 176 (97%), complete gross resection; 123 (60%), postoperative chemotherapy; 56(28%), no additional treatment. Five-year PFS, 83% (95% confidence interval [CI]: 76.6%-87.8%); 5-year overall survival (OS), 92.7% (95% CI: 87.7%-95.8%). Age, stage, and surgical staging were associated with improved 5-year PFS, and younger age at diagnosis with improved 5-year OS (p < 0.001). Chemotherapy did not improve 5-year PFS in IA/IB versus observation, but improved survival in IC (hazard ratio [HR]: 1.01, 95% CI: 0.22-4.59, p = 0.99; HR: 0.17, 95% CI: 0.04-0.7, p = 0.006).
CONCLUSIONS
Age, stage, and full surgical staging were associated with improved 5-year PFS. Chemotherapy showed no benefit in IA/IB disease.
背景
子宫内膜样卵巢癌（EEOC）较为罕见，其治疗方法也未得到明确界定。我们研究了手术治疗 EEOC 后与 5 年无进展生存（PFS）相关的因素。
方法
回顾性研究：2002 年 1 月至 2017 年 9 月，在我们医院初次手术或初次手术后 3 个月内就诊的所有 EEOC 患者的治疗和结局。
结果
共确定了 212 例患者。中位随访时间为 63.9 个月（范围，0.7-192）；中位诊断年龄为 52 岁（范围，20-88）；疾病分期：I 期，n=145（68%）；II 期，n=47（22%）；III/IV 期，n=20（9%）；国际妇产科联合会（FIGO）分级：1 级，n=127（60%）；2 级，n=66（31%）；3 级，n=17（8%）；未知，n=2（1%）。128 例（60%）合并子宫内膜异位症；75 例（35%）为同时性子宫内膜样子宫内膜癌（80%，IA）；101 例（48%）行完全手术分期；8 例（5%）盆腔淋巴结（LN）阳性；6 例（4%）腹主动脉旁 LN 阳性；176 例（97%）行完全大体肿瘤切除；123 例（60%）行术后化疗；56 例（28%）未行其他治疗。5 年 PFS 为 83%（95%CI：76.6%-87.8%）；5 年总生存率（OS）为 92.7%（95%CI：87.7%-95.8%）。年龄、分期和手术分期与 5 年 PFS 改善相关，而诊断时年龄较小与 5 年 OS 改善相关（p<0.001）。IA/IB 期与观察组相比，化疗并未改善 5 年 PFS，但在 IC 期改善了生存（风险比[HR]：1.01，95%CI：0.22-4.59，p=0.99；HR：0.17，95%CI：0.04-0.7，p=0.006）。
结论
年龄、分期和完全手术分期与 5 年 PFS 改善相关。IA/IB 期疾病化疗无获益。
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