Department of Gynecology and Obstetrics, First Affiliated Hospital, Jilin University, Jilin, P. R. China.
Department of Oncology, General Hospital of Northern Theater Command, Dalian Medical University, Shenyang, P. R. China.
PLoS One. 2024 Apr 18;19(4):e0299504. doi: 10.1371/journal.pone.0299504. eCollection 2024.
To examine the trends in morbidity and mortality among ovarian cancer patients with liver metastases, and investigate the impact of different treatments on both overall survival (OS) and cancer-specific survival (CSS).
2,925 ovarian cancer patients with liver metastases from Surveillance, Epidemiology, and End Results 2010-2019 were included. The primary endpoint was considered as OS and CSS. We conducted trend analysis of the incidence, OS and CSS rates of liver metastases in ovarian cancer. Univariate and multivariate COX proportional risk models were used to investigate the association between different treatment methods and OS, and univariate and multivariate competing risk models were employed to evaluate the impact of treatment methods on CSS.
At the end of follow-up, 689 patients remained alive. The OS and CSS rates were 76.44% and 72.99% for all patients, respectively. There was a significant decreasing trend in the incidence [average annual percent change (AAPC) = -2.3, 95% confidence interval (CI): -3.9, -0.7], all-cause mortality (AAPC = -12.8, 95% CI: -15.6, -9.9) and specific mortality (AAPC = -13.0, 95% CI: -16.1, -9.8) rate of liver metastases in ovarian cancer. After adjusting all confounding factor, only receiving surgery was associated with OS [hazard ratio (HR) = 0.39, 95%CI: 0.31-0.48]/CSS (HR = 0.37, 95%CI: 0.30-0.47). Chemotherapy was found to be protective factor for OS (HR = 0.33, 95%CI: 0.30-0.37)/CSS (HR = 0.44, 95%CI: 0.39-0.50) of ovarian cancer patients, while not receiving surgery remained a risk factor. Additionally, the result of subgroup analyses also showed that only receiving surgery and chemotherapy still were significant protective factor of OS and CSS for patients without other distant metastases, with distant metastases to the bone, lung, brain or other organs, with bone metastasis, and with lung metastasis.
Our research has elucidated a downward trend in morbidity and mortality rates among patients with liver metastases originating from ovarian cancer. Only receiving surgery and chemotherapy as therapies methods confer survival benefits to patients.
本研究旨在探讨卵巢癌肝转移患者的发病率和死亡率趋势，并分析不同治疗方法对总生存期（OS）和癌症特异性生存期（CSS）的影响。
纳入了 2010 年至 2019 年期间监测、流行病学和最终结果（SEER）数据库中 2925 例卵巢癌伴肝转移患者。主要终点为 OS 和 CSS。我们对卵巢癌肝转移的发病率、OS 和 CSS 进行了趋势分析。采用单因素和多因素 COX 比例风险模型探讨不同治疗方法与 OS 的关系，采用单因素和多因素竞争风险模型评估治疗方法对 CSS 的影响。
随访结束时，689 例患者存活。所有患者的 OS 和 CSS 率分别为 76.44%和 72.99%。卵巢癌肝转移的发病率呈显著下降趋势（平均年变化百分比[AAPC] = -2.3，95%置信区间[CI]：-3.9，-0.7），全因死亡率（AAPC = -12.8，95%CI：-15.6，-9.9）和特异性死亡率（AAPC = -13.0，95%CI：-16.1，-9.8）。调整所有混杂因素后，只有手术治疗与 OS（风险比[HR] = 0.39，95%CI：0.31-0.48）/CSS（HR = 0.37，95%CI：0.30-0.47）相关。化疗是卵巢癌患者 OS（HR = 0.33，95%CI：0.30-0.37）/CSS（HR = 0.44，95%CI：0.39-0.50）的保护因素，而未手术治疗仍是卵巢癌患者 OS（HR = 0.63，95%CI：0.56-0.71）/CSS（HR = 0.66，95%CI：0.59-0.74）的危险因素。此外，亚组分析结果还表明，只有手术和化疗仍然是无远处转移、远处转移至骨、肺、脑或其他器官、骨转移和肺转移患者 OS 和 CSS 的显著保护因素。
本研究阐明了卵巢癌肝转移患者发病率和死亡率呈下降趋势。只有手术和化疗作为治疗方法才能为患者带来生存获益。
