Son Joo-Hyuk, Lee Jimin, Yum Sun-Hyung, Kim Jeeyeon, Kong Tae-Wook, Chang Suk-Joon, Ryu Hee-Sug
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea.
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon 16499, Korea.
Cancers (Basel). 2022 Aug 18;14(16):3987. doi: 10.3390/cancers14163987.
(1) Background: Multiple confounding factors influence the indications for secondary cytoreductive surgery (SCS) in patients with ovarian cancer (OC). We aimed to identify the factors associated with patients most likely to benefit from SCS. (2) Methods: We retrospectively reviewed the medical records of patients with recurrent ovarian cancer from 2003 to 2021. The potential factors influencing treatment outcomes and survival between patients who received chemotherapy alone and those who received SCS after recurrence were evaluated. (3) Results: Recurrent OC was identified in 262 patients, with a median age of 53 (20-80) years. Of these patients, 87.4% had an initial stage III/IV disease. Eighty-nine (34%) patients received SCS. The median survival was 41.0 (95% confidence interval [CI], 37.4-44.5) months and 88.0 (95% CI, 64.2-111.7) months in the chemotherapy and surgery groups, respectively. A multivariate analysis showed limited regional carcinomatosis (single region or up to three regions with limited carcinomatosis) ( = 0.045) as the only significant factor for predicting no residual disease after SCS. In platinum-sensitive recurrent patients with limited regional recurrence, the complete resection rate was 87.6%. (4) Conclusions: SCS had a significant impact on survival in the selected patient population. Limited regional recurrence (single region or up to three regions with limited carcinomatosis) may be a simple criterion for SCS in platinum-sensitive recurrent OC patients.
(1) 背景：多种混杂因素影响卵巢癌（OC）患者二次减瘤手术（SCS）的指征。我们旨在确定最有可能从SCS中获益的患者相关因素。(2) 方法：我们回顾性分析了2003年至2021年复发性卵巢癌患者的病历。评估了影响单纯接受化疗的患者与复发后接受SCS的患者治疗结果和生存的潜在因素。(3) 结果：共确定262例复发性OC患者，中位年龄53（20 - 80）岁。这些患者中，87.4%为初始Ⅲ/Ⅳ期疾病。89例（34%）患者接受了SCS。化疗组和手术组的中位生存期分别为41.0（95%置信区间[CI]，37.4 - 44.5）个月和88.0（95%CI，64.2 - 111.7）个月。多因素分析显示，局限性区域癌灶（单个区域或多达三个有局限性癌灶的区域）（P = 0.045）是预测SCS后无残留疾病的唯一显著因素。在铂敏感的局限性区域复发患者中，完全切除率为87.6%。(4) 结论：SCS对选定患者群体的生存有显著影响。局限性区域复发（单个区域或多达三个有局限性癌灶的区域）可能是铂敏感复发性OC患者进行SCS的一个简单标准。
