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.
J Surg Oncol. 2021 Oct;124(5):846-851. doi: 10.1002/jso.26597. Epub 2021 Jul 16.
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.
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.
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).
Age, stage, and full surgical staging were associated with improved 5-year PFS. Chemotherapy showed no benefit in IA/IB disease.
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。
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。
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）。
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。
