卵巢卵黄囊瘤患者的生存结果和新型风险分层系统的建立。
Survival outcomes and establishment of a novel risk stratification system in patients with ovarian yolk sac tumors.
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.
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.
出版信息
Gynecol Oncol. 2023 Nov;178:145-152. doi: 10.1016/j.ygyno.2023.10.006. Epub 2023 Oct 19.
OBJECTIVE
To evaluate the survival outcomes and establish a risk stratification system in patients with ovarian yolk sac tumors (OYST).
METHODS
The recurrence-free survival (RFS), disease-specific survival (DSS), and prognostic factors were retrospectively evaluated in 151 OYST patients treated in our hospital between 2006 and 2022. A risk stratification system based on the identified prognostic factors was established.
RESULTS
The median follow-up time was 5.1 years, with a 5-year RFS and DSS rate of 75.5% and 91.2%, respectively. FIGO stage III-IV and the interval between treatment and normalization of AFP were two prognostic predictors. Significant differences in RFS and DSS (both P < 0.001) were identified between patients who had normalized AFP ≤ 3 and ≥ 4 cycles of chemotherapy, or among patients who had normalized AFP after ≤2, 3-4, and ≥ 5 cycles of chemotherapy. FIGO stage I - II and stage III-IV were scored as 0 and 2, respectively. AFP normalization ≤2, 3, 4, and ≥ 5 cycles of chemotherapy were scored as 0, 1, 2, and 4, respectively. A total score of 0-1, 2-3, and ≥ 4 were stratified patients into low-risk (96 patients), intermediate-risk (35 patients), and high-risk groups (20 patients), respectively. Patients in three risk stratifications manifested significant differences in both RFS and DSS (P < 0.0001).
CONCLUSION
This risk stratification system based on tumor stage and the interval between treatment and normalization of AFP may help to guide clinical management by dividing OYST patients into three risk groups.
目的
评估卵巢卵黄囊瘤（OYST）患者的生存结局并建立风险分层系统。
方法
回顾性分析 2006 年至 2022 年我院收治的 151 例 OYST 患者的无复发生存（RFS）、疾病特异性生存（DSS）和预后因素。根据确定的预后因素建立风险分层系统。
结果
中位随访时间为 5.1 年，5 年 RFS 和 DSS 率分别为 75.5%和 91.2%。FIGO 分期 III-IV 期和 AFP 恢复正常与治疗之间的间隔是两个预后预测因素。在 AFP 恢复正常的患者中，接受≤3 和≥4 个周期化疗的患者之间，以及 AFP 恢复正常的患者中，接受≤2、3-4 和≥5 个周期化疗的患者之间，RFS 和 DSS 差异均有统计学意义（均 P<0.001）。FIGO 分期 I-II 期和 III-IV 期分别评分为 0 和 2。AFP 恢复正常的时间为≤2、3、4 和≥5 个周期化疗分别评分为 0、1、2 和 4。总分为 0-1、2-3 和≥4 的患者分为低危（96 例）、中危（35 例）和高危组（20 例），三组患者的 RFS 和 DSS 差异均有统计学意义（P<0.0001）。
结论
该风险分层系统基于肿瘤分期和 AFP 恢复正常与治疗之间的间隔，可以帮助指导临床管理，将 OYST 患者分为低危、中危和高危三组。
Zotero 插件