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原发性输卵管癌和高级别浆液性卵巢癌的临床病理及预后因素分析:一项单机构回顾性研究

Clinicopathological and prognostic factor analyses of primary fallopian tube carcinoma and high-grade serous ovarian cancer: a single-institution retrospective study.

作者信息

Tu Mengyan, Gao Xueyan, Guo Tianchen, Lu Weiguo, Xu Junfen

机构信息

Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.

Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

World J Surg Oncol. 2025 Jan 4;23(1):8. doi: 10.1186/s12957-024-03636-7.

Abstract

OBJECTIVE

This study aimed to evaluate and compare the clinicopathologic features of primary fallopian tubal carcinoma (PFTC) and high-grade serous ovarian cancer (HGSOC) and explore the prognostic factors of these two malignant tumors.

METHODS

Fifty-seven patients diagnosed with PFTC from 2006 to 2015 and 60 patients diagnosed with HGSOC from 2014 to 2015 with complete prognostic information were identified at Women's Hospital of Zhejiang University. The clinicopathological and surgical data were collected, and the survival of the patients was followed for 5 years after surgery. The Cox proportional risk model was used to analyze the impact on survival.

RESULTS

For PFTC patients, the mean age was 57 years (range, 35-77 years). The most common clinical manifestations were abnormal vaginal bleeding and/or discharge (61%). A total of 72% of the cases were found at the early stage, and 90% of the tumors were high grade (51 cases). 51% of patients were diagnosed with PFTC before surgery, while the rest were misdiagnosed. Twenty-one patients relapsed. The overall survival (OS) rate was 82%. OS was significantly related to FIGO stage, the preoperative serum CA 125 level, lymphadenectomy, residual tumor size, appendectomy, and the number of cycles of chemotherapy. However, only FIGO stage was an independent prognostic variable for OS. For patients with HGSOC, the OS rate was 67%. OS was significantly related to FIGO stage, residual tumor size, and laterality. However, only residual tumor size was an independent prognostic variable for OS.

CONCLUSIONS

Our study provides important clinicopathologic insights into PFTC and HGSOC. We identified FIGO stage as an independent prognostic factor for PFTC patients and residual tumor size as an independent prognostic factor for HGSOC patients. These findings emphasize the critical role of accurate staging and achieving a residual tumor size of less than 1 cm during surgery. Our research contributes to refining clinical decision-making, supporting the importance of optimal surgical outcomes, and guiding personalized treatment strategies to improve patient prognosis in both PFTC and HGSOC patients.

摘要

目的

本研究旨在评估和比较原发性输卵管癌(PFTC)和高级别浆液性卵巢癌(HGSOC)的临床病理特征,并探讨这两种恶性肿瘤的预后因素。

方法

在浙江大学医学院附属妇产科医院确定了2006年至2015年诊断为PFTC的57例患者以及2014年至2015年诊断为HGSOC且具有完整预后信息的60例患者。收集临床病理和手术数据,并在术后对患者的生存情况进行5年随访。采用Cox比例风险模型分析对生存的影响。

结果

PFTC患者的平均年龄为57岁(范围35 - 77岁)。最常见的临床表现为异常阴道出血和/或分泌物(61%)。共72%的病例在早期被发现,90%的肿瘤为高级别(51例)。51%的患者在手术前被诊断为PFTC,其余被误诊。21例患者复发。总生存率(OS)为82%。OS与国际妇产科联盟(FIGO)分期、术前血清CA 125水平、淋巴结清扫术、残留肿瘤大小、阑尾切除术及化疗周期数显著相关。然而,只有FIGO分期是OS的独立预后变量。对于HGSOC患者,OS率为67%。OS与FIGO分期、残留肿瘤大小及肿瘤侧别显著相关。然而,只有残留肿瘤大小是OS的独立预后变量。

结论

我们的研究为PFTC和HGSOC提供了重要的临床病理见解。我们确定FIGO分期为PFTC患者的独立预后因素,残留肿瘤大小为HGSOC患者的独立预后因素。这些发现强调了准确分期以及在手术中使残留肿瘤大小小于1 cm的关键作用。我们的研究有助于优化临床决策,支持实现最佳手术效果的重要性,并指导个性化治疗策略以改善PFTC和HGSOC患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/661a/11699645/2d7950d67f93/12957_2024_3636_Fig1_HTML.jpg

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