Maastricht University GROW School for Oncology and Reproduction, Maastricht, The Netherlands
Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands.
Int J Gynecol Cancer. 2024 May 6;34(5):722-729. doi: 10.1136/ijgc-2023-004955.
This study aimed to assess the outcomes of patients with early stage mucinous ovarian carcinoma based on subtype (expansile vs infiltrative).
We retrospectively analyzed all surgically treated patients with mucinous ovarian carcinoma in the Netherlands (2015-2020), using data from national registries. Subtypes were determined, with any ambiguities resolved by a dedicated gynecologic pathologist. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage I were categorized into full staging, fertility-sparing, or partial stagings. Outcomes were overall survival and recurrence free survival, and recurrence rates.
Among 409 identified patients, 257 (63%) had expansile and 152 (37%) had infiltrative tumors. Patients with expansile tumors had FIGO stage I more frequently (n=243, 95% vs n=116, 76%, p<0.001). For FIGO stage I disease, patients with expansile and infiltrative tumors underwent similar proportions of partial (n=165, 68% vs n=78, 67%), full (n=32, 13% vs n=23, 20%), and fertility-sparing stagings (n=46, 19% vs n=15, 13%) (p=0.139). Patients with expansile FIGO stage I received less adjuvant chemotherapy (n=11, 5% vs n=24, 21%, p<0.001), exhibited better overall and recurrence free survival (p=0.006, p=0.012), and fewer recurrences (n=13, 5% vs n=16, 14%, p=0.011). Survival and recurrence rates were similar across the expansile extent of staging groups. Patients undergoing fertility-sparing staging for infiltrative tumors had more recurrences compared with full or partial stagings, while recurrence free survival was similar across these groups. Full staging correlated with better overall survival in infiltrative FIGO stage I (p=0.022).
While most patients with FIGO stage I underwent partial staging, those with expansile had better outcomes than those with infiltrative tumors. Full staging was associated with improved overall survival in infiltrative, but not in expansile FIGO stage I. These results provide insight for tailored surgical approaches.
本研究旨在根据亚型（膨胀型与浸润型）评估早期黏液性卵巢癌患者的结局。
我们回顾性分析了荷兰（2015-2020 年）所有接受手术治疗的黏液性卵巢癌患者的数据，这些数据来自国家登记处。通过专门的妇科病理学家确定了亚型，并解决了任何不确定的问题。国际妇产科联合会（FIGO）分期为 I 期的患者分为全面分期、保留生育力分期或部分分期。结局为总生存率和无复发生存率，以及复发率。
在确定的 409 名患者中，257 名（63%）患者为膨胀型，152 名（37%）患者为浸润型肿瘤。膨胀型肿瘤患者更常出现 FIGO 分期 I 期（n=243，95% vs n=116，76%，p<0.001）。对于 FIGO 分期 I 期疾病，膨胀型和浸润型肿瘤患者接受相似比例的部分（n=165，68% vs n=78，67%）、全面（n=32，13% vs n=23，20%）和保留生育力分期（n=46，19% vs n=15，13%）（p=0.139）。膨胀型 FIGO 分期 I 期患者接受的辅助化疗较少（n=11，5% vs n=24，21%，p<0.001），总生存率和无复发生存率较好（p=0.006，p=0.012），复发率较低（n=13，5% vs n=16，14%，p=0.011）。在膨胀型分期组中，生存和复发率相似。接受浸润型肿瘤保留生育力分期的患者复发率高于全面或部分分期，而这些组的无复发生存率相似。全面分期与浸润型 FIGO 分期 I 期的总生存率提高相关（p=0.022）。
尽管大多数 FIGO 分期 I 期患者接受了部分分期，但膨胀型患者的结局优于浸润型患者。在浸润型患者中，全面分期与更好的总生存率相关，但在膨胀型患者中则不然。这些结果为量身定制的手术方法提供了依据。
