卵巢癌全国性调查。六、对当前国际妇产科联盟分期系统的批判性评估。

National survey of ovarian carcinoma. VI. Critical assessment of current International Federation of Gynecology and Obstetrics staging system.

作者信息

Nguyen H N, Averette H E, Hoskins W, Sevin B U, Penalver M, Steren A

机构信息

Department of Obstetrics & Gynecology, University of Miami School of Medicine, Florida 33101.

出版信息

Cancer. 1993 Nov 15;72(10):3007-11. doi: 10.1002/1097-0142(19931115)72:10<3007::aid-cncr2820721024>3.0.co;2-n.

DOI:10.1002/1097-0142(19931115)72:10<3007::aid-cncr2820721024>3.0.co;2-n

PMID:8221569

Abstract

BACKGROUND

The Commission on Cancer of the American College of Surgeons recently completed a national survey of patients with ovarian cancer. From the large database, the prognostic value of current International Federation of Gynecology and Obstetrics (FIGO) staging system for ovarian carcinoma was re-examined.

METHODS

Data was collected from 25 consecutive ovarian carcinomas diagnosed in 1983 and 1988 at 904 hospitals with cancer programs. Among a total of 12,316 cases, 5156 patients had long-term survival data.

RESULTS

The overall 5-year survivals were 88.9 +/- 0.9%; 57.1 +/- 2.4%; 23.8 +/- 1.3%; and 11.6 +/- 0.9% for Stages I, II, III, and IV, respectively. Pairwise survival comparisons using Lee-Desu statistic confirmed the prognostic value of current staging system (P < 0.00001). When survival data was substratified further to substage division, the 5-year survivals were: IA, 92.1 +/- 0.9%; IB, 84.9 +/- 3.4%; IC, 82.4 +/- 2.0%; IIA, 69.0 +/- 4.3%; IIB, 56.4 +/- 3.6%; IIC, 51.4 +/- 4.5%; IIIA, 39.3 +/- 2.8%; IIIB, 25.5 +/- 2.6%; IIIC, 17.1 +/- 1.4%; and IV, 11.6 +/- 0.9%. As the disease process becomes more advanced, patients' survival reduces proportionally. However, the survival reduction is relatively small between IB-IC and IIB-IIC divisions. Survival comparisons revealed significant prognostic value for most substage divisions (P = 0.03-0.0002) except for IB-IC and IIB-IIC combinations (P > 0.33). Further analyses revealed no significant differences between IB-IC and IIB-IIC patients in several prognostic parameters such as age, histologic grade, cell type, and amount of residual disease.

CONCLUSIONS

These data support the current FIGO staging system. However, Substages IB-IC and IIB-IIC should be combined to respective single substages.

摘要

背景

美国外科医师学会癌症委员会最近完成了一项针对卵巢癌患者的全国性调查。从这个大型数据库中，重新审视了当前国际妇产科联盟（FIGO）卵巢癌分期系统的预后价值。

方法

收集了1983年和1988年在904家设有癌症项目的医院连续诊断出的25例卵巢癌的数据。在总共12316例病例中，5156例患者有长期生存数据。

结果

I、II、III和IV期的总体5年生存率分别为88.9±0.9%；57.1±2.4%；23.8±1.3%；和11.6±0.9%。使用Lee-Desu统计量进行的成对生存比较证实了当前分期系统的预后价值（P<0.00001）。当生存数据进一步按亚分期细分时，5年生存率分别为：IA期，92.1±0.9%；IB期，84.9±3.4%；IC期，82.4±2.0%；IIA期，69.0±4.3%；IIB期，56.4±3.6%；IIC期，51.4±4.5%；IIIA期，39.3±2.8%；IIIB期，25.5±2.6%；IIIC期，17.1±1.4%；IV期，11.6±0.9%。随着疾病进程的进展，患者的生存率相应降低。然而，IB-IC期和IIB-IIC期之间的生存率降低相对较小。生存比较显示，除了IB-IC期和IIB-IIC期组合（P>0.33）外，大多数亚分期的预后价值都很显著（P=0.03-0.0002）。进一步分析显示，IB-IC期和IIB-IIC期患者在年龄、组织学分级、细胞类型和残留病灶数量等几个预后参数方面没有显著差异。