Nuthalapati Sravanthi, Kundargi Rajshekhar S, Reddihalli Pallavi V, Rathod Praveen S, Krishnappa Shobha
Department of Gynaecologic Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, 560029 Karnataka India.
Indian J Surg Oncol. 2022 Dec;13(4):707-715. doi: 10.1007/s13193-022-01543-5. Epub 2022 May 5.
The aim of this study was to evaluate the clinico-pathological behaviour and treatment patterns of low-grade serous carcinomas (LGSC) of ovary treated at a regional cancer centre. A retrospective analysis was done for the histopathology-proven cases of low-grade serous ovarian carcinoma, treated at a tertiary cancer institute between January, 2010, and September, 2019. There were 28 patients identified from the medical records with low-grade serous ovarian carcinoma. Median age of the patients was 43 years [22-79 years]. Average BMI was 22.3 ± 4.0 kg/m [range 15.2-31.2]. Twenty-one (75%) were parous and 7 (25%) were non-parous women. Median CA125 level was 188 IU/ml [range 6-14,187 IU/ml]. Ten (35.7%) patients had primary surgery elsewhere and 8 (80%) out of these patients had to undergo repeat staging. Fertility sparing surgery (FSS) was offered to 4 (14.3%) patients. Five (17.8%) patients had received neoadjuvant chemotherapy for advanced disease and poor performance status. Almost 82.2% (23) of the patients had no macroscopic residual disease at the primary surgery. According to International Federation of Obstetrics and Gynaecologists (FIGO) stage for ovarian carcinoma, there were 7 (25%), 6 (21.4%), 13 (46.4%), and 2 (7.1%) patients in the stages I, II, III, and IV respectively. Post-operative adjuvant chemotherapy was offered to 7 (25%), hormonal therapy (anastrozole/tamoxifen) to 7 (25%), and rest of 14 (50%) patients were under surveillance. Median follow-up time for the study group was 36 months. Overall survival (OS) and disease-free survival (DFS) at 2 years was 96.4% and 89.1%, respectively. Low-grade serous carcinomas of ovary differ biologically from high-grade serous ovarian carcinoma. Surgery is the cornerstone of the treatment. Further research is needed to understand the behaviour of these tumours for effective treatment strategies in future.
本研究旨在评估在某区域癌症中心接受治疗的卵巢低级别浆液性癌（LGSC）的临床病理行为及治疗模式。对2010年1月至2019年9月期间在某三级癌症研究所接受治疗的经组织病理学证实的卵巢低级别浆液性癌病例进行了回顾性分析。从病历中确定了28例卵巢低级别浆液性癌患者。患者的中位年龄为43岁[22 - 79岁]。平均体重指数为22.3±4.0kg/m²[范围15.2 - 31.2]。21例（75%）为经产妇，7例（25%）为未产妇。CA125的中位水平为188IU/ml[范围6 - 14,187IU/ml]。10例（约35.7%）患者在其他地方接受了初次手术，其中8例（80%）患者不得不接受再次分期手术。4例（14.3%）患者接受了保留生育功能手术（FSS）。5例（17.8%）患者因疾病进展和身体状况较差接受了新辅助化疗。几乎82.2%（23例）患者在初次手术时无肉眼可见的残留病灶。根据国际妇产科联盟（FIGO）的卵巢癌分期，I期、II期、III期和IV期的患者分别有7例（25%）、6例（21.4%）、13例（46.4%）和2例（7.1%）。7例（25%）患者接受了术后辅助化疗，7例（约25%）患者接受了激素治疗（阿那曲唑/他莫昔芬），其余14例（50%）患者接受观察。研究组的中位随访时间为36个月。2年时的总生存率（OS）和无病生存率（DFS）分别为96.4%和89.1%。卵巢低级别浆液性癌在生物学特性上与高级别浆液性卵巢癌不同。手术是治疗的基石。未来需要进一步研究以了解这些肿瘤的行为，从而制定有效的治疗策略。
