Department of Obstetrics and Gynecology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Department of Pathology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Acta Obstet Gynecol Scand. 2023 Jul;102(7):935-941. doi: 10.1111/aogs.14578. Epub 2023 Apr 14.
Primary ovarian carcinoids are extremely rare ovarian tumors, and there is limited data available on their clinical characteristics and survival outcomes.
We conducted a historical cohort study of 56 patients to investigate their clinical characteristics. The overall survival, disease-specific survival, recurrence-free survival, and potential prognostic factors of these patients were also evaluated.
The median age of these patients was 42.0 years (range: 20-71). The average mass and carcinoid size was 7.3 and 0.4 cm, respectively. Elevated tumor marker levels and ascites were observed in 15 and 10 patients, respectively. In 98.2% of the patients, tumors were confined to the ovary, while only one had metastatic disease. Surgery was the mainstay therapy: 37.5% of the patients underwent unilateral salpingo-oophorectomy, 25.0% underwent hysterectomy with bilateral salpingo-oophorectomy, 21.4% underwent ovarian cystectomy, 10.7% underwent comprehensive staging surgery, and 5.4% underwent bilateral salpingo-oophorectomy. Appendectomy and lymphadenectomy were performed in eight and five patients, respectively, but none showed tumor involvement. Chemotherapy was the only adjuvant treatment utilized, and was administered in four patients. Pathological analysis showed that strumal carcinoid was the most predominant subtype, occurring in 66.1% of the patients. The Ki-67 index was reported in 39 patients, 30 of which had an index of no more than 3%, with a maximum of only 5%. Only one relapse occurred after the initial treatment, and that patient experienced recurrences on two occasions, maintaining stable disease after surgery and octreotide therapy. After a median follow-up of 3.6 years, 96.4% of the patients achieved no evidence of disease, while 3.6% were alive with the disease. The 5-year recurrence-free survival rate was 97.9% and no death occurred. No risk factors for recurrence-free survival, overall survival, or disease-specific survival were identified.
The Ki-67 indices were extremely low and prognoses were excellent in patients with primary ovarian carcinoids. Conservative surgery, especially unilateral salpingo-oophorectomy, is preferred. Individualized adjuvant therapy may be considered for patients with metastatic diseases.
原发性卵巢类癌是一种极为罕见的卵巢肿瘤，其临床特征和生存结果的数据有限。
我们对 56 例患者进行了历史队列研究，以调查其临床特征。还评估了这些患者的总生存率、疾病特异性生存率、无复发生存率和潜在的预后因素。
这些患者的中位年龄为 42.0 岁（范围：20-71 岁）。平均肿块和类癌大小分别为 7.3 和 0.4cm。15 例患者肿瘤标志物水平升高，10 例患者有腹水。98.2%的患者肿瘤局限于卵巢，仅有 1 例发生转移。手术是主要的治疗方法：37.5%的患者行单侧附件切除术，25.0%行子宫切除术加双侧附件切除术，21.4%行卵巢囊肿切除术，10.7%行全面分期手术，5.4%行双侧附件切除术。8 例患者行阑尾切除术，5 例患者行淋巴结切除术，但均未见肿瘤累及。仅 4 例患者接受化疗作为辅助治疗。病理分析显示，其中以柱状细胞类癌最常见，占 66.1%。报告了 39 例患者的 Ki-67 指数，其中 30 例指数不超过 3%，最高仅为 5%。初始治疗后仅 1 例复发，该患者两次复发，手术和奥曲肽治疗后病情稳定。中位随访 3.6 年后，96.4%的患者无疾病证据，3.6%的患者存活且患有疾病。5 年无复发生存率为 97.9%，无死亡。未发现无复发生存、总生存或疾病特异性生存的风险因素。
原发性卵巢类癌患者的 Ki-67 指数极低，预后极好。保守手术，特别是单侧附件切除术，是首选。对于转移性疾病患者，可考虑个体化辅助治疗。
