Department of Obstetrics and Gynecology, Obstetrics and Gynecology University of Health Sciences Turkey, Ankara Etlik Zubeyde Hanım Women's Health and Research Center Turkey, Ankara, Turkey.
Department of Gynecology Oncology, Obstetrics and Gynecology University of Health Sciences Turkey, Ankara Etlik Zubeyde Hanım Women's Health and Research Center Turkey, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2024 Nov;302:125-133. doi: 10.1016/j.ejogrb.2024.09.005. Epub 2024 Sep 7.
To compare overall survival (OS) and morbidity outcomes in patients with advanced epithelial ovarian/tubal/peritoneal cancer undergoing standard-radical (SR) and ultra-radical (UR) surgical procedures based on NICE classification.
This retrospective study analyzed data from 282 patients with 2014 FIGO stage III-IV epithelial ovarian cancer operated on between January 2006 and January 2019. The study compared OS, progression-free survival (PFS), and morbidity between SR and UR surgeries. Parameters influencing OS, including preoperative, postoperative, and post-adjuvant chemotherapy CA-125 values, surgical procedures, post-surgical residual tumor, histopathological grade, and FIGO surgical stage, were assessed.
Out of 282 patients, 256 met the inclusion criteria. SR surgery was performed in 48 %, and UR surgery in 52 %. The mean preoperative CA-125 value was 1200 ± 1914.83, decreasing to 240.32 ± 373.87 postoperatively. The mean follow-up period was 63.01 ± 47.56 months. UR surgery correlated with significantly higher postoperative complications (p < 0.001), histopathological grade (p = 0.023), FIGO stage (p < 0.001), three-year death rates, and overall mortality rates (p = 0.035). FIGO stage and total metastatic lymph nodes emerged as independent prognostic factors for overall and PFS.
In the treatment of epithelial ovarian cancer, evaluating the extent of the tumor before the surgery and showing maximal effort to minimize the residual tumor volume instead of applying UR procedures as the first choice seems to be the most important factor that can affect survival.
根据 NICE 分类，比较接受标准根治性（SR）和超根治性（UR）手术的晚期上皮性卵巢/输卵管/腹膜癌患者的总生存（OS）和发病率结果。
本回顾性研究分析了 2006 年 1 月至 2019 年 1 月期间接受手术治疗的 282 例 2014 年 FIGO 分期 III-IV 上皮性卵巢癌患者的数据。该研究比较了 SR 和 UR 手术的 OS、无进展生存（PFS）和发病率。评估了影响 OS 的参数，包括术前、术后和辅助化疗 CA-125 值、手术程序、术后残留肿瘤、组织病理学分级和 FIGO 手术分期。
在 282 例患者中，256 例符合纳入标准。SR 手术占 48%，UR 手术占 52%。术前 CA-125 值的平均值为 1200±1914.83，术后降至 240.32±373.87。平均随访时间为 63.01±47.56 个月。UR 手术与更高的术后并发症（p<0.001）、组织病理学分级（p=0.023）、FIGO 分期（p<0.001）、三年死亡率和总死亡率（p=0.035）显著相关。FIGO 分期和总转移淋巴结是 OS 和 PFS 的独立预后因素。
在治疗上皮性卵巢癌时，评估手术前肿瘤的范围并尽力最小化残留肿瘤体积，而不是将 UR 手术作为首选，似乎是影响生存的最重要因素。
