Department of Obstetrics and Gynecology, Nagoya University, Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, Japan; Department of Obstetrics and Gynecology, Handa City Handa Hospital, Japan.
Department of Obstetrics and Gynecology, Nagoya University, Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, Japan.
Eur J Obstet Gynecol Reprod Biol. 2021 Dec;267:221-225. doi: 10.1016/j.ejogrb.2021.11.015. Epub 2021 Nov 16.
The aim of this study was to investigate long-term post-recurrence survival outcomes in young women receiving fertility-sparing surgery (FSS) to verify the feasibility of the limited surgery for epithelial ovarian cancer (OvCa).
We performed a regional multicenter retrospective study from January 1986 and March 2020, using clinical data corrected under the central pathological review system. Patients with recurrent tumor after surgery for stage I epithelial OvCa, aged equal or younger than 45 years were included for this study. We evaluated effect of FSS regarding long-term post-recurrence survival with statistical adjustment of propensity score-based method.
With the Kaplan-Meier method, original and adjusted survival curves were estimated for recurrence-after survival of patients with (n = 14) and without FSS (n = 26). Median time to disease-specific death was 18.6 months. In both original and adjusted cohorts, there were no significant difference between the two groups (log rank test; P > 0.05). Hazard ratio of disease-specific death was 1.264 (95% confidence interval, 0.563-2.836; P = 0.570) in original and 1.354 (95% confidence interval, 0.702-2.611; P = 0.366) in adjusted population. This result indicated that patients with FSS was not associated with poorer prognosis for recurrence-after survival than those without. When comparing patients not receiving FSS, patients receiving FSS with recurrence at spared ovary followed not significantly different survival outcome as well as those with extra-ovarian recurrence.
There was no significant difference of long-term post-recurrence survival outcomes between patients of epithelial OvCa with and without FSS in young women of reproductive age.
本研究旨在探讨接受保留生育功能手术（FSS）的年轻女性患者在复发后的长期生存结局，以验证对上皮性卵巢癌（OvCa）进行有限手术的可行性。
我们进行了一项区域性多中心回顾性研究，研究时间为 1986 年 1 月至 2020 年 3 月，使用了中央病理审查系统校正后的临床数据。纳入研究的患者为接受 I 期上皮性 OvCa 手术后复发且年龄等于或小于 45 岁的患者。我们采用基于倾向评分匹配的方法对 FSS 对长期复发后生存的影响进行了统计学调整。
采用 Kaplan-Meier 法，对有（n=14）和无（n=26）FSS 的患者的复发后生存的原始和调整后的生存曲线进行了估计。疾病特异性死亡的中位时间为 18.6 个月。在原始和调整队列中，两组之间无显著差异（对数秩检验；P>0.05）。原始队列中疾病特异性死亡的风险比为 1.264（95%置信区间，0.563-2.836；P=0.570），调整队列中为 1.354（95%置信区间，0.702-2.611；P=0.366）。这一结果表明，与未接受 FSS 的患者相比，接受 FSS 的患者的复发后生存预后并不差。当比较未接受 FSS 的患者时，接受 FSS 且保留卵巢复发的患者与额外卵巢复发的患者的生存结局并无显著差异。
在年轻有生育能力的上皮性 OvCa 患者中，接受 FSS 与未接受 FSS 的患者在复发后的长期生存结局无显著差异。
