Pan-Birmingham Gynaecological Cancer Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, West Midlands, UK.
Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
Int J Gynecol Cancer. 2024 Sep 2;34(9):1399-1407. doi: 10.1136/ijgc-2024-005332.
Primary mucinous ovarian carcinoma represents 3% of ovarian cancers and is typically diagnosed early, yielding favorable outcomes. This study aims to identify risk factors, focussing on the impact of age and ethnicity on survival from primary mucinous ovarian cancer.
A retrospective observational study of patients treated at Sandwell and West Birmingham Hospitals NHS Trust and University Hospital Coventry and Warwickshire. Patients included were women aged ≥16 years, with primary mucinous ovarian cancer confirmed by specialist gynecological histopathologist and tumor immunohistochemistry, including cytokeratin-7, cytokeratin-20, and CDX2. Statistical analyses were performed using R integrated development environment, with survival assessed by Cox proportional hazards models and Kaplan-Meier plots.
A total of 163 patients were analyzed; median age at diagnosis was 58 years (range 16-92), 145 (89%) were International Federation of Gynecology and Obstetrics stage I and 43 (26%) patients had infiltrative invasion. Women aged ≤45 years were more likely to have infiltrative invasion (RR=1.38, 95% CI 0.78 to 2.46), with increased risk of death associated with infiltrative invasion (HR=2.29, 95% CI 1.37 to 5.83). Compared with White counterparts, South Asian women were more likely to undergo fertility-sparing surgery (RR=3.52, 95% CI 1.48 to 8.32), and have infiltrative invasion (RR=1.25, 95% CI 0.60 to 2.58). South Asian women undergoing fertility-sparing surgery had worse prognosis than those undergoing traditional staging surgery (HR=2.20, 95% CI 0.39 to 13.14). In FIGO stage I disease, 59% South Asian and 37% White women received adjuvant chemotherapy (p=0.06). South Asian women exhibited a worse overall prognosis than White women (HR=2.07, 95% CI 0.86 to 4.36), particularly pronounced in those aged ≤45 years (HR=8.75, 95% CI 1.22 to 76.38).
This study identified young age as a risk factor for diagnosis of infiltrative invasion. Fertility-sparing surgery in South Asian women is a risk factor for poorer prognosis. South Asian women exhibit poorer overall survival than their White counterparts.
原发性黏液性卵巢癌占卵巢癌的 3%，通常早期诊断，预后良好。本研究旨在确定风险因素，重点关注年龄和种族对原发性黏液性卵巢癌生存的影响。
这是一项在桑德韦尔和西米德兰兹郡西部大学医院信托基金和考文垂和沃里克郡大学医院进行的回顾性观察性研究。纳入的患者为年龄≥16 岁、经妇科病理学家和肿瘤免疫组织化学（包括细胞角蛋白-7、细胞角蛋白-20 和 CDX2）确诊为原发性黏液性卵巢癌的女性。使用 R 集成开发环境进行统计分析，采用 Cox 比例风险模型和 Kaplan-Meier 图评估生存情况。
共分析了 163 例患者；中位诊断年龄为 58 岁（范围 16-92），145 例（89%）为国际妇产科联合会（FIGO）分期 I 期，43 例（26%）患者有浸润性侵犯。≤45 岁的女性更有可能发生浸润性侵犯（RR=1.38，95%CI 0.78 至 2.46），且与浸润性侵犯相关的死亡风险增加（HR=2.29，95%CI 1.37 至 5.83）。与白人相比，南亚女性更有可能接受保留生育能力的手术（RR=3.52，95%CI 1.48 至 8.32），且更有可能发生浸润性侵犯（RR=1.25，95%CI 0.60 至 2.58）。接受保留生育能力手术的南亚女性比接受传统分期手术的女性预后更差（HR=2.20，95%CI 0.39 至 13.14）。在 FIGO Ⅰ期疾病中，59%的南亚人和 37%的白人女性接受了辅助化疗（p=0.06）。南亚女性的总体预后比白人女性差（HR=2.07，95%CI 0.86 至 4.36），尤其是≤45 岁的女性（HR=8.75，95%CI 1.22 至 76.38）。
本研究确定了年轻是浸润性侵犯诊断的一个风险因素。南亚女性接受保留生育能力的手术是预后较差的一个风险因素。南亚女性的总体生存率比白人女性差。
