Wu Liangcai, Shi Shuo, Sun Hong, Zhang Haiyan
Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Front Oncol. 2022 May 16;12:862944. doi: 10.3389/fonc.2022.862944. eCollection 2022.
The aim of this study was to investigate the prognostic value and stratification cutoff point for tumor size in stage I ovarian clear cell carcinoma (OCCC).
This was a retrospective cohort study using the Surveillance, Epidemiology, and End Results database (version: SEER 8.3.9). Patients diagnosed with stage I OCCC from 1988 to 2018 were included for further analysis. X-Tile software was used to identify the potential cutoff point for tumor size. Stratification analysis, propensity score matching, and inverse probability weighting analysis were used to balance the potential confounding factors.
A total of 1,000 stage I OCCC patients were included. Of these 1,000 patients, median follow-up was 106 months (95% confidence interval [CI]: 89-112 months). Multivariate analysis showed that tumor size, age at diagnosis, and stage IC were significantly associated with stage I OCCC patients. Eight centimeters is a promising cutoff point that can divide stage I OCCC patients into a good or a poor prognosis group. After controlling potential confounding factors with propensity score matching and inverse probability weighting, we demonstrated that stage I OCCC patients with tumor size ≤ 8 cm enjoyed a significantly better 5-year overall survival (OS, 89.8% vs. 81%, < 0.0001). Tumor size ≤ 8 cm was an independent prognostic factor of stage I OCCC patients (hazard ratio [HR] 0.5608, 95% CI: 0.4126-0.7622, = 0.0002).
Tumor size is an independent prognostic factor for stage I OCCC, and 8 cm is a promising cutoff point for tumor size for risk stratification. However, using tumor size in the stratification management of stage I OCCC patients warrants further investigation.
本研究旨在探讨肿瘤大小对Ⅰ期卵巢透明细胞癌（OCCC）的预后价值及分层截断点。
这是一项回顾性队列研究，使用监测、流行病学和最终结果数据库（版本：SEER 8.3.9）。纳入1988年至2018年诊断为Ⅰ期OCCC的患者进行进一步分析。使用X-Tile软件确定肿瘤大小的潜在截断点。采用分层分析、倾向评分匹配和逆概率加权分析来平衡潜在的混杂因素。
共纳入1000例Ⅰ期OCCC患者。在这1000例患者中，中位随访时间为106个月（95%置信区间[CI]：89 - 112个月）。多因素分析显示，肿瘤大小、诊断时年龄和ⅠC期与Ⅰ期OCCC患者显著相关。8厘米是一个有前景的截断点，可将Ⅰ期OCCC患者分为预后良好或不良组。在用倾向评分匹配和逆概率加权控制潜在混杂因素后，我们证明肿瘤大小≤8厘米的Ⅰ期OCCC患者5年总生存率显著更高（OS，89.8%对81%，<0.0001）。肿瘤大小≤8厘米是Ⅰ期OCCC患者的独立预后因素（风险比[HR] 0.5608，95% CI：0.4126 - 0.7622，=0.0002）。
肿瘤大小是Ⅰ期OCCC的独立预后因素，8厘米是肿瘤大小进行风险分层的有前景的截断点。然而，在Ⅰ期OCCC患者的分层管理中使用肿瘤大小仍需进一步研究。
