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初次接受肿瘤细胞减灭术的Ⅱ期和Ⅲ期上皮性卵巢癌患者合并腹膜癌转移的潜在预后影响

The Potential Prognostic Impact of Associated Peritoneal Carcinomatosis in Patients with Stage II and III Epithelial Ovarian Cancer Who Had Upfront Complete Cytoreduction.

作者信息

Fahim Mohamed Ibrahim, Allam Rasha Mahmoud

机构信息

Surgical Oncology Department, National Cancer Institute-Cairo University, 1 Kasr El-Aini Street, Foum El-Khalig, 11796 Egypt.

Biostatistics and Cancer Epidemiology Department, National Cancer Institute-Cairo University, Foum El-Khalig, Egypt.

出版信息

J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):14-17. doi: 10.1007/s13224-024-01965-x. Epub 2024 Mar 25.

Abstract

BACKGROUND

The presence of metastatic peritoneal nodules in epithelial ovarian cancer (EOC) is considered a prognostic factor of both overall survival and disease-free survival. The goal of this study is to assess the potential prognostic effect of associated peritoneal carcinomatosis and PCI in stage II and III EOC patients after undergoing complete cytoreduction (CC score 0 or 1).

PATIENTS AND METHODS

This is a retrospective cohort study including 50 high-grade serous EOC cases treated and followed up from 2012 and 2016. Twenty-three cases had peritoneal nodules at the time of exploration. PCI was assessed intraoperatively in each case. Twenty-seven cases had no peritoneal nodules (were given PCI 0).

RESULTS

The presence of peritoneal nodules, presence of ascites, and stage of the disease had statistically significant impact on overall survival, but with multivariate analysis, only presence of peritoneal nodules was associated with a statistically significant reduced overall survival (HR 6.192; 95% CI 1.248-30.720; value 0.026). The presence of peritoneal nodules was associated with a statistically significant higher incidence of postoperative death ( value 0.038). PCI had no statistically significant impact on overall survival, disease-free survival, or incidence of postoperative death (within 30 days after surgery).

CONCLUSION

The presence of peritoneal nodules had a statistically significant impact on overall survival and incidence of postoperative death. There was no statistically significant prognostic impact of PCI in stage II and III EOC patients who had complete cytoreduction.

摘要

背景

上皮性卵巢癌(EOC)中转移性腹膜结节的存在被认为是总生存期和无病生存期的一个预后因素。本研究的目的是评估在接受完全细胞减灭术(CC评分为0或1)的II期和III期EOC患者中,相关腹膜癌病和腹膜癌指数(PCI)的潜在预后影响。

患者与方法

这是一项回顾性队列研究,纳入了2012年至2016年接受治疗并随访的50例高级别浆液性EOC病例。23例在探查时存在腹膜结节。术中对每例患者评估PCI。27例无腹膜结节(PCI为0)。

结果

腹膜结节的存在、腹水的存在和疾病分期对总生存期有统计学显著影响,但多因素分析显示,只有腹膜结节的存在与总生存期显著降低相关(风险比6.192;95%置信区间1.248 - 30.720;P值0.026)。腹膜结节的存在与术后死亡发生率显著升高相关(P值0.038)。PCI对总生存期、无病生存期或术后死亡发生率(术后30天内)无统计学显著影响。

结论

腹膜结节的存在对总生存期和术后死亡发生率有统计学显著影响。在接受了完全细胞减灭术的II期和III期EOC患者中,PCI无统计学显著的预后影响。

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本文引用的文献

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Peritoneal cancer index: a prognostic indicator of survival in advanced ovarian cancer.
Eur J Surg Oncol. 2003 Feb;29(1):69-73. doi: 10.1053/ejso.2002.1380.

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