Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan;
Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
In Vivo. 2022 Sep-Oct;36(5):2453-2460. doi: 10.21873/invivo.12980.
BACKGROUND/AIM: The 2014 International Federation of Gynecology and Obstetrics (FIGO) classification subdivides patients with stage IIIA1 ovarian, fallopian tube, and peritoneal cancers by the greatest dimension of metastatic lymph node without supporting evidence. This study aimed to assess the validity of this subdivision.
A retrospective single-institution cohort study was performed in patients with ovarian, fallopian tube, or peritoneal cancer from 2009 to 2020. We compared outcomes between patients diagnosed with IIIA1(i) (metastasis ≤10 mm in the greatest dimension) and IIIA1(ii) (metastasis >10 mm in the greatest dimension).
Of the 895 patients, 46 (5.1%) were classified as stage IIIA1, 20 as IIIA1(i), and 26 as IIIA1(ii). In stage IIIA1(ii), there were significantly more cases of serous carcinoma (p<0.001), and the number of positive nodes and lymph node ratio were significantly higher than those in stage IIIA1(i) (p=0.001, p=0.002). Five-year progression-free survival was 68.7% in patients with stage IIIA1(i) cancer and 58.1% in those with stage IIIA1(ii) (p=0.58). Five-year overall survival was 83.1% in patients with stage IIIA1(i) cancer and 80.2% in those with stage IIIA1(ii) (p=0.44). Among other patient characteristics and pathologic findings, there were no prognostic factors for patients with stage IIIA1 cancer.
In this retrospective cohort study, further classification of FIGO stage IIIA1 cancer was not significantly associated with patient outcomes.
背景/目的：2014 年国际妇产科联盟（FIGO）分类将 IIIA1 期卵巢、输卵管和腹膜癌患者按转移性淋巴结最大径分为无支持证据的亚组。本研究旨在评估这一分组的有效性。
回顾性单机构队列研究纳入了 2009 年至 2020 年期间患有卵巢、输卵管或腹膜癌的患者。我们比较了诊断为 IIIA1(i)（最大径转移性淋巴结≤10mm）和 IIIA1(ii)（最大径转移性淋巴结>10mm）患者的结局。
在 895 例患者中，46 例（5.1%）被归类为 IIIA1 期，其中 20 例为 IIIA1(i)，26 例为 IIIA1(ii)。在 IIIA1(ii)期，浆液性癌的病例明显更多（p<0.001），阳性淋巴结数和淋巴结比率明显高于 IIIA1(i)期（p=0.001，p=0.002）。IIIA1(i)期患者的 5 年无进展生存率为 68.7%，IIIA1(ii)期为 58.1%（p=0.58）。IIIA1(i)期患者的 5 年总生存率为 83.1%，IIIA1(ii)期为 80.2%（p=0.44）。在其他患者特征和病理发现中，IIIA1 期癌症患者无预后因素。
在这项回顾性队列研究中，FIGO 分期 IIIA1 癌症的进一步分类与患者结局无显著相关性。
