Bai Lu, Zhao Shuhua, Xu Jia, Gao Yan, He Yuanyuan, Ren Yanjie, Zhang Xiaohong
Department of Gynecology and Obstetrics, Xijing Hospital, The Fourth Military Medical University Xi'an 710032, Shaanxi, China.
Am J Cancer Res. 2025 Aug 15;15(8):3603-3616. doi: 10.62347/LKZC2827. eCollection 2025.
To investigate the surgical outcomes and prognostic factors of neoadjuvant chemotherapy (NACT) combined with interval debulking surgery (IDS) in patients with advanced ovarian cancer.
A retrospective analysis was conducted on clinical data of 97 patients with advanced ovarian cancer admitted to Xijing Hospital of The Fourth Military Medical University from January 2018 to December 2019. The patients were divided into two groups based on their treatment methods: a control group (primary debulking surgery (PDS), n=48) and an observation group (NACT combined with IDS, n=49). Short-term efficacy, perioperative outcomes, tumor markers, immune function, quality of life, adverse reactions, and survival status were compared between the two groups. Factors affecting prognosis were analyzed, a Nomogram prediction model was constructed and validated.
The observation group demonstrated superior short-term efficacy than the control group, with lower intraoperative blood loss, shorter hospitalization duration, and reduced transfusion volume (<0.05). After treatment, tumor marker levels, immune function, and quality of life improved significantly in both groups compared to pre-treatment levels, with more pronounced improvements in the observation group (<0.05). The incidence of adverse reactions such as liver injury, kidney injury, nausea and vomiting, and myelosuppression was lower in the observation group than in the control group (<0.05). Additionally, no significant difference in 5-year progression-free survival (PFS) and overall survival (OS) was observed between the two groups (>0.05). Univariate and multivariate regression analyses identified age ≥50 years, tumor size >10 cm, low differentiation, PDS, and presence of residual lesions as independent prognostic factors. The Nomogram prediction model achieved an AUC of 0.955 (95% CI: 0.917-0.993), with calibration curves closely aligning with the ideal line, indicating high predictive accuracy and reliability.
NACT combined with IDS demonstrated superior short-term efficacy compared to traditional PDS in patients with advanced ovarian cancer, with improved perioperative conditions, reduced adverse reactions, and enhanced survival rates. Age, tumor size, histological differentiation, and treatment modality independently affect patient prognosis. The Nomogram prediction model developed in this study demonstrates excellent discriminative power and clinical applicability for prognostic evaluation.
探讨新辅助化疗（NACT）联合间隔减瘤手术（IDS）治疗晚期卵巢癌患者的手术效果及预后因素。
回顾性分析2018年1月至2019年12月第四军医大学西京医院收治的97例晚期卵巢癌患者的临床资料。根据治疗方法将患者分为两组：对照组（初始减瘤手术（PDS），n = 48）和观察组（NACT联合IDS，n = 49）。比较两组的短期疗效、围手术期结局、肿瘤标志物、免疫功能、生活质量、不良反应及生存状况。分析影响预后的因素，构建并验证列线图预测模型。
观察组短期疗效优于对照组，术中出血量少、住院时间短、输血量少（<0.05）。治疗后，两组肿瘤标志物水平、免疫功能及生活质量均较治疗前显著改善，观察组改善更明显（<0.05）。观察组肝损伤、肾损伤、恶心呕吐及骨髓抑制等不良反应发生率低于对照组（<0.05）。此外，两组5年无进展生存期（PFS）和总生存期（OS）差异无统计学意义（>0.05）。单因素和多因素回归分析确定年龄≥５０岁、肿瘤大小>10 cm、低分化、PDS及存在残留病灶为独立预后因素。列线图预测模型的AUC为0.955（95%CI：0.917-0.993），校准曲线与理想线紧密吻合，表明预测准确性和可靠性高。
与传统PDS相比，NACT联合IDS治疗晚期卵巢癌患者短期疗效更佳，围手术期情况改善，不良反应减少，生存率提高。年龄、肿瘤大小、组织学分化及治疗方式独立影响患者预后。本研究建立的列线图预测模型在预后评估方面具有出色的判别能力和临床适用性。
