Klin Onkol. 2022 Winter;35(1):63-71. doi: 10.48095/ccko202263.
Primary peritoneal carcinoma (PPC) at presentation often masquerades as epithelial ovarian carcinoma (OC) but behaves different with respect to treatment response, recurrence patterns and has inferior outcomes. The objective of this study is to compare the clinicopathological features and survival outcomes of PPC and OC.
Prospectively maintained database of patients presenting to the gynecologic oncology department at a tertiary hospital was reviewed between 1st January 2010 and 31st December 2020. A comparative analysis of high-grade serous stage III/IV PPC and OC was done. Demographics, treatment details, complications and survival outcomes were collected from electronic medical records.
151 OC and 69 PPC patients were included. A higher proportion of women with PPC had reduced performance status prior to hysterectomy with salpingo-oophorectomy, a shorter symptom to treatment interval, and large volume ascites. A significantly lower number of women with PPC (4.3 vs. 46.1%; P < 0.001) underwent primary cytoreduction, had a lower median surgical complexity score (3 vs. 4; P < 0.001) but higher recurrence rates (66.7 vs. 47.0%; P = 0.041) as compared to the patients with OC. The median progression-free survival (PFS) was 18 (15-20) months in PPC and 23 (17-28) months in OC patients (log-rank P = 0.034), while the median overall survival (OS) was similar (44 vs. 48 months; log-rank P = 0.696). The presence of extraperitoneal disease and interval cytoreduction was associated with shorter PFS. Suboptimal cytoreduction and delay in adjuvant chemotherapy beyond 6 weeks post-surgery was associated with reduced OS.
PPC is an aggressive disease with lower PFS compared to OC. Commonly presenting with large volume carcinomatosis, it is not amenable for primary cytoreduction, making the usage of neoadjuvant chemotherapy a common practice and pragmatic approach.
原发性腹膜癌（PPC）在发病时常常表现为上皮性卵巢癌（OC），但其治疗反应、复发模式有所不同，预后较差。本研究旨在比较 PPC 和 OC 的临床病理特征和生存结局。
回顾性分析 2010 年 1 月 1 日至 2020 年 12 月 31 日期间在一家三级医院妇科肿瘤科就诊的患者的前瞻性维护数据库。对高级别浆液性 III/IV 期 PPC 和 OC 进行了对比分析。从电子病历中收集人口统计学、治疗细节、并发症和生存结局等数据。
共纳入 151 例 OC 和 69 例 PPC 患者。与 OC 患者相比，更多的 PPC 患者在子宫切除和双侧附件切除术前体力状况较差，症状至治疗的间隔时间较短，腹水较多。接受初次肿瘤细胞减灭术的 PPC 患者比例明显较低（4.3%比 46.1%；P < 0.001），手术复杂度评分中位数较低（3 分比 4 分；P < 0.001），但复发率较高（66.7%比 47.0%；P = 0.041）。PPC 患者的中位无进展生存期（PFS）为 18（15-20）个月，OC 患者为 23（17-28）个月（对数秩检验 P = 0.034），中位总生存期（OS）相似（44 比 48 个月；对数秩检验 P = 0.696）。腹膜外疾病的存在和间隔时间内的肿瘤细胞减灭术与较短的 PFS 相关。辅助化疗不充分和术后 6 周后延迟开始与 OS 降低相关。
PPC 是一种侵袭性疾病，与 OC 相比 PFS 较短。由于常表现为大量癌性腹水，其不适合初次肿瘤细胞减灭术，因此常采用新辅助化疗，这是一种常见的治疗方法。
