对于接受保留生育功能手术的早期上皮性卵巢癌年轻女性，是否需要辅助化疗？：一项多中心回顾性分析。
Is adjuvant chemotherapy necessary for young women with early-stage epithelial ovarian cancer who have undergone fertility-sparing surgery?: a multicenter retrospective analysis.
机构信息
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Truma-cho 65, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
出版信息
BMC Womens Health. 2022 Mar 21;22(1):80. doi: 10.1186/s12905-022-01642-z.
OBJECTIVE
In young patients with early-stage epithelial ovarian carcinoma (EOC) who were received fertility-sparing surgery (FSS), the role of adjuvant chemotherapy is unclear. Here, we performed a multicenter study using inverse probability of treatment weighting (IPTW) to explore the effect of chemotherapy on patients' survival.
METHODS
Between 1987 and 2015, a retrospective study was carried out, including 1183 patients with stage I EOC. Among them, a total of 101 women with stage I EOC who underwent FSS were investigated, including 64 and 37 patients with or without adjuvant chemotherapy, respectively. Oncologic outcomes were compared between the two arms using original and IPTW cohorts.
RESULTS
During 62.6 months (median) of follow-up, recurrence was noted in 11 (17.2%) women in the chemotherapy arm and 6 (16.2%) patients in the observation arm. In the unweighted cohort, the 5-year overall and recurrence-free survival (OS/RFS) rates of chemotherapy and observation arms were 86.3/80.8 and 90.2/79.8%, respectively. There was no significant difference between the two groups {Log-rank: P = 0.649 (OS)/P = 0.894 (RFS)}. In the IPTW cohort after adjusting for various clinicopathologic covariates, we also failed to identify a difference in RFS/OS between the two groups {RFS (chemotherapy vs. observation), HR: 0.501 (95% CI 0.234-1.072), P = 0.075: OS (chemotherapy vs. observation), HR: 0.939 (95% CI 0.330-2.669), P = 0.905}.
CONCLUSIONS
Even after adjusting clinicopathologic covariates, performing adjuvant chemotherapy may not improve the oncologic outcome in young patients who have undergone FSS.
目的
对于接受保留生育功能手术（FSS）的早期上皮性卵巢癌（EOC）年轻患者，辅助化疗的作用尚不清楚。在这里，我们使用逆概率治疗加权（IPTW）进行了一项多中心研究，以探讨化疗对患者生存的影响。
方法
在 1987 年至 2015 年期间进行了一项回顾性研究，纳入了 1183 例 I 期 EOC 患者。其中，对 101 例 I 期 EOC 行 FSS 的患者进行了研究，其中 64 例和 37 例患者分别接受了辅助化疗和观察治疗。使用原始和 IPTW 队列比较了两个治疗组的肿瘤学结果。
结果
在 62.6 个月（中位数）的随访期间，化疗组中有 11 例（17.2%）患者出现复发，观察组中有 6 例（16.2%）患者出现复发。在未加权队列中，化疗组和观察组的 5 年总生存率（OS）/无复发生存率（RFS）分别为 86.3%/80.8%和 90.2%/79.8%。两组之间无显著差异{对数秩检验：P=0.649（OS）/P=0.894（RFS）}。在调整了各种临床病理协变量后，在 IPTW 队列中，我们也未能发现两组之间 RFS/OS 存在差异{RFS（化疗组与观察组），HR：0.501（95%CI 0.234-1.072），P=0.075；OS（化疗组与观察组），HR：0.939（95%CI 0.330-2.669），P=0.905}。
结论
即使在调整了临床病理协变量后，对接受 FSS 的年轻患者进行辅助化疗可能并不能改善其肿瘤学结局。
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