Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
J Ovarian Res. 2022 Dec 1;15(1):125. doi: 10.1186/s13048-022-01063-4.
Complex epithelial neoplasms of the ovary (CENO), an uncommon pathological histotype in ovarian cancer, comprises adenosquamous carcinoma and adenocarcinoma with metaplasia. Owing to the rarity of relevant reports, there are currently no statistics on outcomes based on large samples. Meanwhile high-grade serous ovarian cancer (HGSOC) is the most common histotype in ovarian cancer which has a recognized first-line treatment regimen and poor prognosis. Thus, we aimed to determine the characteristics, prognosis, and independent predictors of survival for CENO, compare them with those of HGSOC and construct prognostic predictive models and nomograms.
We used the Surveillance, Epidemiology, and End Results (SEER) database to determine patients diagnosed with CENO or HGSOC from 2000 to 2017. Clinical, demographic, and treatment characteristics were compared between these groups. Propensity score matching, Cox risk regression analysis, Kaplan-Meier survival curves, and the Least Absolute Shrinkage and Selection Operator regression analysis were employed for analyzing the data.
Here, 31,567 patients with HGSOC and 216 patients with CENO between 2000 and 2017 in the SEER database were enrolled. Age < 57 years, unmarried, and early-stage diseases were more common in patients with CENO than in those with HGSOC. Women with CENO were less likely to receive adjuvant chemotherapy (65.7% vs. 79.4%) but more likely to receive radiotherapy (6.0% vs. 0.8%; both p < 0.001) than those with HGSOC. Year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors for overall and cancer-specific survival in CENO. Overall survival rates were significantly lower for CENO than for more malignant HGSOC.
In summary, CENO was rare in ovarian cancer, while the year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors. Compared with other common malignant ovarian tumors, CENO had a poor prognosis. Prognostic predictive models and nomograms had been determined to predict the individual survival rates of patients with CENO. These methods could improve evaluations of survival and therapeutic decisions for patients.
卵巢复杂上皮性肿瘤（CENO）是卵巢癌中一种罕见的病理组织学类型，包括腺鳞癌和伴有化生的腺癌。由于相关报道较少，目前尚无基于大样本的结局统计数据。同时，高级别浆液性卵巢癌（HGSOC）是卵巢癌中最常见的组织学类型，已有公认的一线治疗方案和不良预后。因此，我们旨在确定 CENO 的特征、预后和独立生存预测因素，并将其与 HGSOC 进行比较，构建预后预测模型和诺模图。
我们使用监测、流行病学和最终结果（SEER）数据库，确定 2000 年至 2017 年间诊断为 CENO 或 HGSOC 的患者。比较两组患者的临床、人口统计学和治疗特征。采用倾向评分匹配、Cox 风险回归分析、Kaplan-Meier 生存曲线和最小绝对收缩和选择算子回归分析进行数据分析。
本研究共纳入 SEER 数据库中 2000 年至 2017 年间 31567 例 HGSOC 患者和 216 例 CENO 患者。与 HGSOC 患者相比，CENO 患者年龄<57 岁、未婚和疾病早期更为常见。CENO 患者接受辅助化疗的比例较低（65.7% vs. 79.4%），但接受放疗的比例较高（6.0% vs. 0.8%；均 P<0.001）。诊断年份、手术状态、肿瘤数量、分级和 FIGO 分期是 CENO 患者总生存和癌症特异性生存的独立预后因素。CENO 的总生存率明显低于更恶性的 HGSOC。
总之，CENO 在卵巢癌中罕见，而诊断年份、手术状态、肿瘤数量、分级和 FIGO 分期是独立的预后因素。与其他常见的恶性卵巢肿瘤相比，CENO 的预后较差。已经确定了预测 CENO 患者个体生存率的预后预测模型和诺模图。这些方法可以提高对患者生存的评估和治疗决策。
