Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Division of Clinical Genetics, Department of Laboratory Medicine, Lund University Graduate School of Medicine, Lund, Sweden.
Int J Gynaecol Obstet. 2024 Sep;166(3):1225-1231. doi: 10.1002/ijgo.15479. Epub 2024 Apr 12.
Ovarian carcinoma (OvCa) is more common in the elderly, but also affects the adolescent and young adult (AYA) generation, which refers to those aged 15-39 years. Although the characteristics of OvCa may differ between AYAs and non-AYAs, limited information is currently available on differences in prognostic factors. Therefore, we herein investigated prognostic factors for and the prognosis of OvCa in AYAs. We also examined the prognostic impact of fertility-sparing surgery in a subgroup analysis.
We retrospectively collected data on 4897 patients with OvCa from the databases of multiple institutions and ultimately included 1161 patients with epithelial ovarian cancer (EOC). We performed a survival analysis to compare AYAs and non-AYAs with backgrounds that conformed to those of AYAs using the propensity score (PS) matching method. A Cox regression analysis was also conducted to evaluate each predictor of recurrence-free survival (RFS) and overall survival (OS) in the original population. As a subgroup analysis, a multivariate analysis stratified by the AYA and non-AYA generations was performed.
In total, 119 AYA patients were included in this study. After PS adjustments, no significant differences were observed in RFS or OS between AYAs and non-AYAs. Prognostic factors differed between AYAs and non-AYAs, particularly in histology and cytology. A multivariate analysis stratified by the AYA and non-AYA generations described that uterine-preserving surgery (UPS) did not have a significant impact on the prognosis of AYAs or non-AYAs. In cases with recurrence, no significant differences were observed in RFS and recurrent sites in the two groups.
Characteristic prognostic factors for EOC in AYAs were identified. The present results indicate the limited prognostic impact of UPS for EOC in AYAs.
卵巢癌（OvCa）在老年人中更为常见，但也影响青少年和年轻成年人（AYA）群体，即年龄在 15-39 岁之间的人群。尽管 AYA 与非 AYA 之间的 OvCa 特征可能存在差异，但目前关于预后因素的信息有限。因此，我们在此研究了 AYA 中 OvCa 的预后因素和预后。我们还在亚组分析中检查了保留生育能力手术的预后影响。
我们从多个机构的数据库中回顾性收集了 4897 名 OvCa 患者的数据，最终纳入了 1161 名上皮性卵巢癌（EOC）患者。我们使用倾向评分（PS）匹配法对符合 AYA 背景的 AYA 和非 AYA 进行生存分析比较。我们还进行了 Cox 回归分析，以评估原始人群中无复发生存（RFS）和总生存（OS）的每个预测因素。作为亚组分析，对 AYA 和非 AYA 两个世代进行了多变量分析。
本研究共纳入 119 名 AYA 患者。在 PS 调整后，AYA 和非 AYA 之间的 RFS 或 OS 无显著差异。预后因素在 AYA 和非 AYA 之间存在差异，特别是在组织学和细胞学方面。按 AYA 和非 AYA 世代分层的多变量分析表明，保留子宫手术（UPS）对 AYA 或非 AYA 的预后没有显著影响。在复发的情况下，两组的 RFS 和复发部位无显著差异。
确定了 AYA 中 EOC 的特征性预后因素。本研究结果表明，UPS 对 AYA 中 EOC 的预后影响有限。
