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同时性子宫内膜癌和卵巢癌患者的治疗结果及预后因素

Outcomes and prognostic factors in patients with synchronous endometrial and ovarian cancer.

作者信息

Lu Xiaofei, Zhu Honglan

机构信息

Department of Obstetrics and Gynecology, Peking University People's Hospital, Peking University, Beijing, 100044, China.

出版信息

Arch Gynecol Obstet. 2025 Sep 4. doi: 10.1007/s00404-025-08164-7.

Abstract

PURPOSE

To analyze prognostic factors and survival outcomes in patients with synchronous endometrial and ovarian cancer (SEOC) to guide clinical management.

METHODS

We conducted a retrospective cohort study of patients diagnosed with SEOC at Peking University People's Hospital between January 2004 and December 2024. Clinicopathological data were collected, and oncological outcomes, including progression-free survival (PFS) and overall survival (OS), were analyzed along with their associated prognostic factors.

RESULTS

Among 64 included patients, vaginal bleeding was the predominant presenting symptom. Thirty-six patients were diagnosed with concordant endometrioid carcinoma, which was the most common histological type. All patients underwent surgical treatment, among whom 56 received platinum-based chemotherapy postoperatively, with a platinum sensitivity rate of 67.9%. The median PFS and OS were 27 months (range 3-215) and 41 months (range 7-246), respectively. On multivariate analysis, advanced FIGO stage of ovarian cancer (HR = 2.764; 95% CI 1.169-6.536, P = 0.021) independently predicted worse PFS, while platinum resistance (HR = 6.962; 95% CI 2.052-23.619, P = 0.002) was significantly associated with reduced OS.

CONCLUSIONS

In this cohort, platinum sensitivity was observed in 67.9% of cases. The advanced ovarian FIGO stage and platinum resistance independently correlated with inferior survival, underscoring the urgent need for tailored therapeutic strategies and intensified surveillance in platinum-resistant SEOC.

摘要

目的

分析同步性子宫内膜癌和卵巢癌(SEOC)患者的预后因素及生存结局,以指导临床管理。

方法

我们对2004年1月至2024年12月期间在北京大学人民医院被诊断为SEOC的患者进行了一项回顾性队列研究。收集临床病理数据,并分析肿瘤学结局,包括无进展生存期(PFS)和总生存期(OS)及其相关预后因素。

结果

在纳入的64例患者中,阴道出血是主要的首发症状。36例患者被诊断为一致性子宫内膜样癌,这是最常见的组织学类型。所有患者均接受了手术治疗,其中56例术后接受了铂类化疗,铂敏感性率为67.9%。PFS和OS的中位数分别为27个月(范围3 - 215个月)和41个月(范围7 - 246个月)。多因素分析显示,卵巢癌国际妇产科联盟(FIGO)晚期(HR = 2.764;95%CI 1.169 - 6.536,P = 0.021)独立预测PFS较差,而铂耐药(HR = 6.962;95%CI 2.052 - 23.619,P = 0.002)与OS降低显著相关。

结论

在该队列中,67.9%的病例观察到铂敏感性。卵巢FIGO晚期和铂耐药与较差的生存独立相关,强调了对铂耐药SEOC制定针对性治疗策略和加强监测的迫切需求。

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