中国老年上皮性卵巢癌患者预后更差吗？
Do ethnic chinese older adults with epithelial ovarian cancer survive a poorer prognosis?
机构信息
Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
出版信息
J Ovarian Res. 2023 Jun 6;16(1):110. doi: 10.1186/s13048-023-01177-3.
BACKGROUND
The risk of suffering epithelial ovarian cancer (EOC) for women increases with age evidently, while the prognosis of older EOC patients remain unclear. Against the backdrop of the accelerate aging process in China, this paper investigates whether the older EOC patients have a lower overall survival probability than the younger patients based on the sample of ethnic Chinese population.
METHODS
A total of 323 ethnic Chinese patients diagnosed as epithelial ovarian cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We compared the overall survival probability between the younger group (< 70 years) and the older patients group (≥ 70 years). Survival curves were drawn using the Kaplan-Meier method, comparisons among different subgroups were evaluated using log-rank tests, and independent prognostic factors were identified by univariate and multivariate Cox regression analyses.
RESULTS
43 patients were (13.3%) in the older patients group and 280 (86.7%) in the younger group. The distribution patterns between two groups were significantly different with regard to marital status, histologic type and FIGO stage. The median overall survival (OS) was significantly longer in the younger group than the older patients group (not reached vs. median 39 months, p < 0.05). The multivariate analysis demonstrated that the age (The older vs. the younger, HR: 1.967, P = 0.007), primary tumor laterality (HR: 1.849, P = 0.009), and FIGO stage (III vs. I, HR: 3.588, P = 0.001; and IV vs. I, HR: 4.382, P = 0.001; respectively) remained as important risk factors while Histology (HGSOC vs. CCOC, HR: 0.479, P = 0.025; and LGSOC/MOC/EC vs. CCOC, HR: 0.390, P = 0.034; respectively) and the number of lymph node dissected more than 10 was a protective factor (HR: 0.397, P = 0.008). In an analysis of 104 pairs of patients matched on the basis of the propensity score, the older patients group had significantly lower overall mortality (HR = 2.561, P = 0.002).
CONCLUSION
Ethnic Chinese Older EOC patients have a worse prognosis than the younger patients.
背景
女性患上皮性卵巢癌（EOC）的风险随年龄明显增加，而老年 EOC 患者的预后仍不清楚。在中国人口加速老龄化的背景下，本研究基于中国人群样本，探讨老年 EOC 患者的总体生存率是否低于年轻患者。
方法
从监测、流行病学和最终结果（SEER）数据库中提取了 323 名诊断为上皮性卵巢癌的中国患者。我们比较了年轻组（<70 岁）和老年患者组（≥70 岁）的总体生存率。使用 Kaplan-Meier 方法绘制生存曲线，对数秩检验比较不同亚组之间的差异，单因素和多因素 Cox 回归分析确定独立预后因素。
结果
43 例患者（13.3%）为老年患者组，280 例（86.7%）为年轻患者组。两组之间的分布模式在婚姻状况、组织学类型和 FIGO 分期方面存在显著差异。年轻组的中位总生存期（OS）明显长于老年患者组（未达到 vs. 中位 39 个月，p<0.05）。多因素分析表明，年龄（老年 vs. 年轻，HR：1.967，P=0.007）、原发肿瘤侧别（HR：1.849，P=0.009）和 FIGO 分期（III 期 vs. I 期，HR：3.588，P=0.001；IV 期 vs. I 期，HR：4.382，P=0.001）仍然是重要的危险因素，而组织学类型（HGSOC 与 CCOC，HR：0.479，P=0.025；LGSOC/MOC/EC 与 CCOC，HR：0.390，P=0.034）和淋巴结清扫数目超过 10 个是保护因素（HR：0.397，P=0.008）。在基于倾向评分对 104 对患者进行匹配分析后，老年患者组的总死亡率显著降低（HR=2.561，P=0.002）。
结论
中国老年 EOC 患者的预后比年轻患者差。
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