University of Ioannina, Stavros Niarchou Avenue, Ioannina 45110, Greece.
Gustave Roussy, Département de médecine oncologique, F-94805 Villejuif, France.
Cancer Epidemiol. 2021 Dec;75:102045. doi: 10.1016/j.canep.2021.102045. Epub 2021 Oct 9.
To determine the differential effect of the treatment periods on the survival of patients with stage IV serous papillary peritoneal carcinoma (SPPC), fallopian tube cancers, and epithelial ovarian cancers (EOC).
This was an exploratory, population-based observational study of all patients with stage IV SPPC, fallopian tube cancers, and EOC collected from the SEER Research Data 1973-2017. The study period was divided into three time-periods: platinum combinations before the taxane era (1990-1995), platinum plus taxane chemotherapy era (1996-2013), and bevacizumab era (2014-2017).
A total of 9828 patients were eligible for analyses: SPPC (3898 patients; 39.7%), fallopian tube cancers (1290 patients; 13.1%) and EOC (4640 patients, 47.2%). In the 1990-1995 era, the 3-year cause-specific survival was 40% for SPPC, 53% for fallopian tube cancers, and 40% for POC. In the following era 1993-2013, the 3-year cause-specific survival increased to 55% for SPPC, 74% for fallopian tube cancers, and 45% for POC. The last era 2014-2017 showed a 3-year cause-specific survival of 64%, 67%, and 45% for patients with SPPC, fallopian tube cancers, and POC, respectively. The differences in cause-specific survival were statistically significant for patients with SPPC (p=0.004). Multivariable analysis showed that the treatment eras and age at diagnosis were associated with cause-specific survival.
The results of this study are hypothesis-generating and cannot be considered conclusive given the inherent limitations of registry analysis. Subgroup analyses of the phase III randomized controlled trials, by tumor subset (EOC, fallopian tube cancer, and SPPC) would shed more light on the differential effects of novel therapies.
确定治疗期对 IV 期浆液性乳头状腹膜癌(SPPC)、输卵管癌和上皮性卵巢癌(EOC)患者生存的差异影响。
这是一项基于人群的探索性观察研究,纳入了 1973 年至 2017 年 SEER 研究数据中所有 IV 期 SPPC、输卵管癌和 EOC 患者。研究期间分为三个时期:紫杉醇时代前的铂类联合治疗时期(1990-1995 年)、铂类联合紫杉醇化疗时期(1996-2013 年)和贝伐单抗时期(2014-2017 年)。
共有 9828 例患者符合分析条件:SPPC(3898 例,39.7%)、输卵管癌(1290 例,13.1%)和 EOC(4640 例,47.2%)。在 1990-1995 年时期,SPPC、输卵管癌和 EOC 的 3 年特异性生存率分别为 40%、53%和 40%。在随后的 1993-2013 年时期,SPPC、输卵管癌和 EOC 的 3 年特异性生存率分别增加至 55%、74%和 45%。在最后一个时期(2014-2017 年),SPPC、输卵管癌和 EOC 的 3 年特异性生存率分别为 64%、67%和 45%。SPPC 患者的特异性生存率差异具有统计学意义(p=0.004)。多变量分析显示,治疗时期和诊断时的年龄与特异性生存率相关。
由于注册分析固有的局限性,本研究结果是假设性的,不能被认为是结论性的。按肿瘤亚组(EOC、输卵管癌和 SPPC)对 III 期随机对照试验进行亚组分析,将更清楚地了解新疗法的差异影响。