卵巢甲状腺类癌患者的临床特征和生存结局。
Clinical characteristics and survival outcomes in patients with ovarian strumal carcinoid.
机构信息
National Clinical Research Center for Obstetric and Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.
Department of Pathology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People's Republic of China.
出版信息
BMC Cancer. 2022 Oct 24;22(1):1090. doi: 10.1186/s12885-022-10167-5.
BACKGROUND
Ovarian strumal carcinoid is an extremely rare ovarian malignant tumor with limited data on clinical characteristics and survival outcomes.
METHODS
A retrospective study of 119 patients was conducted, including 98 cases identified from literature review, and their clinical characteristics were investigated. The overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and potential prognostic factors of these patients were also evaluated.
RESULTS
Lesions of 115 cases were confined to the ovarian while four patients presented with extra-ovarian disease upon initial diagnosis. Surgical treatment options performed in this cohort varied, 5.0% received ovarian cystectomy, 36.1% received unilateral salpingo-oophorectomy (USO), 7.6% received bilateral salpingo-oophorectomy (BSO), 42.0% received hysterectomy with BSO, and 8.4% underwent debulking surgery. Moreover, one patient did not undergo any surgery. No postoperative adjuvant therapy was administered in 89.9% patients, while 7.6% and 2.5% received adjuvant radiotherapy and chemotherapy, of which two patients received combined radiation and chemotherapy. At the final follow-up, 89.1% patients showed no evidence of the disease, and 5.0% were alive with the disease. Only seven deaths occurred, with two attributed to the tumor. The 5-year, 10-year, and 20-year OS rates were 96.0%, 85.0%, and 85.0%, respectively, with a 15-year recurrence rate of 4.4%. The 5-year and 20-year DSS rate were 98.5% and 95.9%. Multivariate Cox regression showed age ≥ 55 years was the only risk factor associated with the OS (P = 0.014, OR 7.988; 95% CI 1.519 - 42.004). However, the univariate and multivariate Cox regression showed no potential risk factor for RFS and DSS.
CONCLUSION
Patients with ovarian strumal carcinoid have an excellent prognosis irrespective of the surgical option. Conservative surgery especially USO with individualized adjuvant therapy is recommended.
背景
卵巢类癌是一种极为罕见的卵巢恶性肿瘤，其临床特征和生存结果数据有限。
方法
对 119 例患者进行回顾性研究，其中 98 例来自文献复习，并对其临床特征进行了研究。还评估了这些患者的总体生存率（OS）、疾病特异性生存率（DSS）、无复发生存率（RFS）和潜在的预后因素。
结果
115 例病变局限于卵巢，4 例患者初诊时伴有卵巢外疾病。本队列中手术治疗方式多样，5.0%行卵巢囊肿切除术，36.1%行单侧附件切除术（USO），7.6%行双侧附件切除术（BSO），42.0%行子宫切除术加 BSO，8.4%行肿瘤细胞减灭术。此外，有 1 例患者未行任何手术。89.9%的患者未行术后辅助治疗，7.6%和 2.5%的患者分别接受辅助放疗和化疗，其中 2 例患者接受联合放化疗。末次随访时，89.1%的患者无疾病证据，5.0%的患者带瘤生存。仅发生 7 例死亡，其中 2 例与肿瘤有关。5 年、10 年和 20 年 OS 率分别为 96.0%、85.0%和 85.0%，15 年复发率为 4.4%。5 年和 20 年 DSS 率分别为 98.5%和 95.9%。多因素 Cox 回归显示年龄≥55 岁是与 OS 相关的唯一危险因素（P=0.014，OR 7.988；95%CI 1.519-42.004）。然而，单因素和多因素 Cox 回归均未显示出 RFS 和 DSS 的潜在危险因素。
结论
卵巢类癌患者无论选择何种手术方式，预后均极佳。建议行保守手术，尤其是个体化辅助治疗的 USO。
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