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衰老影响晚期卵巢癌隐匿性腹膜扩散的再生:一项多中心回顾性队列研究。

Aging affects regrowth of stealthperitoneal dissemination of advanced ovarian cancer: a multicenter retrospective cohort study.

机构信息

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.

Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia.

出版信息

Sci Rep. 2024 Oct 9;14(1):23537. doi: 10.1038/s41598-024-66419-w.

Abstract

Ovarian cancer (OvCa) is one of the most lethal gynecological malignancies, and most patients are diagnosed at advanced stage with peritoneal dissemination. Although age at diagnosis is considered an independent prognostic factor, its impact on peritoneal recurrence after combined cytoreductive surgery and chemotherapy is not clear. The objective of this study was to investigate the impact of aging on peritoneal recurrence from stealth dissemination and gain insight of the pathophysiology of OvCa in elderly patients. A total of 243 patients with pT2b-pT3 epithelial ovarian who achieved complete surgery, no-residual tumor at first surgery, were selected to be analyzed the risk of peritoneal seeding and recurrence. We found that age over 65 years was independently associated with an increased risk of peritoneum-specific (PS) recurrence (. Furthermore, pT3 stages and positive ascites cytology also worsen the PS-relapse-free survival. Collectively, our findings suggest that age, especially over 65 years, predicts reduced peritoneum-specific tumor recurrence in patients with advanced ovarian cancer after complete cytoreduction surgery, particularly those with pT3 tumors and positive ascites cytology.

摘要

卵巢癌(OvCa)是最致命的妇科恶性肿瘤之一,大多数患者在晚期被诊断为腹膜扩散。尽管诊断时的年龄被认为是一个独立的预后因素,但它对联合细胞减灭术和化疗后腹膜复发的影响尚不清楚。本研究的目的是探讨衰老对隐匿性播散后腹膜复发的影响,并深入了解老年患者 OvCa 的病理生理学。共选择了 243 例 pT2b-pT3 上皮性卵巢癌患者,这些患者均接受了完全手术治疗,首次手术无残留肿瘤,以分析腹膜种植和复发的风险。我们发现,年龄超过 65 岁与腹膜特异性(PS)复发的风险增加独立相关(HR=1.64; 95%CI,1.10-2.44; P=0.014)。此外,pT3 期和阳性腹水细胞学也会恶化 PS 无复发生存。综上所述,我们的研究结果表明,年龄(尤其是 65 岁以上)预测了完全细胞减灭术后晚期卵巢癌患者腹膜特异性肿瘤复发率降低,特别是那些伴有 pT3 肿瘤和阳性腹水细胞学的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9d5/11479624/a839cf0e40df/41598_2024_66419_Fig1_HTML.jpg

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