Joy Jiss, J Kannan, Kumar Satheesh, Arshad Mohamed
Medical Oncology, Madras Medical College, Chennai, IND.
Cureus. 2024 Nov 29;16(11):e74724. doi: 10.7759/cureus.74724. eCollection 2024 Nov.
Background Ovarian cancer is the third most prevalent form of cancer among women in India. The majority of patients are diagnosed at an advanced stage. Many women with late-stage ovarian cancer experience a recurrence and need subsequent treatment, even after initial therapy. The prognosis of patients who experience relapse after treatment is poor. The objective of this study was to assess the clinical characteristics and survival rates of individuals diagnosed with relapsed epithelial ovarian cancer (EOC). Methods This retrospective study included patients with a relapse of epithelial ovarian carcinoma who were treated at the Department of Medical Oncology, Institute of Obstetrics and Gynecology (IOG), Madras Medical College, Chennai, India, over a period of six years, from January 2015 to December 2020. Results Sixty-six patients were enrolled in this study. The median patient age was 52 years. Most patients were postmenopausal (66.67%, n=44) and multiparous (75.76%, n=50). The most common histological type was serous (72.72%, n=48), and the majority of patients were in the later stages of the illness (83.34%, n=55). The median post-relapse survival of the study population was 23 months (95% confidence interval (CI): 20.61-25.39). The median survival of patients who were upfront stage I, II, III, and IV was 30, 13, 23, and nine months, respectively (p<0.05). Patients who underwent optimal cytoreduction had better survival rates than those who did not (28 versus 18 months, p<0.05). The median post-relapse survival was better in the platinum-sensitive group than in the platinum-resistant group (26 versus 16 months, p<0.05). Patients with a single relapse site had better survival rates than those with multiple sites of recurrence (26 versus 13 months, p<0.05). Patients with mucinous histology showed maximum survival (p<0.05). Individuals who initially underwent surgery had superior median survival rates following relapse compared to those who received neoadjuvant chemotherapy as their first treatment (25 versus 23 months, p=0.404). Cox regression analysis revealed that platinum-sensitive patients were 4.204 times more likely to survive than platinum-resistant patients. Similarly, those presenting with single lesions were 7.275 times more likely to survive for a longer time than those with multiple lesions. Conclusion This study emphasizes the importance of achieving optimal cytoreduction and underscores the prognostic significance of platinum sensitivity and recurrence patterns in patients with relapsed ovarian cancer. Late detection can result in unfavorable outcomes.
卵巢癌是印度女性中第三大常见癌症。大多数患者在晚期被诊断出来。许多晚期卵巢癌女性即使在初始治疗后仍会复发并需要后续治疗。治疗后复发的患者预后较差。本研究的目的是评估复发性上皮性卵巢癌(EOC)患者的临床特征和生存率。
这项回顾性研究纳入了2015年1月至2020年12月期间在印度钦奈马德拉斯医学院妇产科研究所医学肿瘤学系接受治疗的上皮性卵巢癌复发患者,为期六年。
本研究共纳入66例患者。患者的中位年龄为52岁。大多数患者为绝经后(66.67%,n = 44)且多产(75.76%,n = 50)。最常见的组织学类型是浆液性(72.72%,n = 48),大多数患者处于疾病晚期(83.34%,n = 55)。研究人群复发后的中位生存期为23个月(95%置信区间(CI):20.61 - 25.39)。初始分期为I、II、III和IV期的患者的中位生存期分别为30、13、23和9个月(p < 0.05)。接受最佳细胞减灭术的患者比未接受的患者生存率更高(28个月对18个月,p < 0.05)。铂敏感组的复发后中位生存期优于铂耐药组(26个月对16个月,p < 0.05)。单一复发部位的患者比多个复发部位的患者生存率更高(26个月对13个月,p < 0.05)。黏液性组织学类型的患者生存期最长(p < 0.05)。最初接受手术的患者复发后的中位生存率高于那些首先接受新辅助化疗的患者(25个月对23个月,p = 0.404)。Cox回归分析显示,铂敏感患者的生存可能性是铂耐药患者的4.204倍。同样,出现单一病灶的患者比有多个病灶的患者长期生存的可能性高7.275倍。
本研究强调了实现最佳细胞减灭术的重要性,并强调了铂敏感性和复发模式对复发性卵巢癌患者预后的意义。晚期检测可能导致不良后果。