Massi D, Susini T, Savino L, Boddi V, Amunni G, Colafranceschi M
Department of Pathology, University of Florence, Italy.
Cancer. 1996 Mar 15;77(6):1131-6.
While ovarian carcinoma is rare in the reproductive age group, these younger patients are known to fare better than the older patients. To determine whether age is an independent prognostic factor, as well as to investigate the clinicopathologic profile and survival rate of young women with ovarian carcinoma, a retrospective analysis in a series of patients aged 40 years or younger was performed.
We collected data on 74 patients with borderline or invasive ovarian carcinoma treated at the Department of Obstetrics and Gynecology at the University of Florence between 1969 and 1994. The median follow-up was 72 months (range, 11-288 months). To assess the clinicopathologic profile and survival differences according to age, the series was subdivided into "very young" (30 years or younger) and "young" (31-40 years) groups of 34 and 40 patients, respectively. Survival rates (Kaplan-Meier method) were compared by the log rank test. A multivariate analysis (Cox proportional hazards) was used to determine the independent effect of each variable on survival.
The overall 5-year and 10-year survival rates were 58.2% and 46.1%, respectively. Several prognostic factors were found significant by univariate analysis, including stage (P < 0.001), grade (P < 0.001), residual disease (P < 0.001), histologic type (P < 0.05), and age (< or = 30 years vs. 31-40 years; P = 0.009). Five year survival rates for the patients age 30 years and younger and patients age 31-40 years were 71.3% and 47.1%, respectively. In the former group, low malignant potential tumors and well differentiated carcinomas were significantly more frequent (68.8% vs. 37.5%; P = 0.01). In the multivariate analysis, only stage (I vs. >I; P = 0.004), grade (0-1 vs. 2-3; P = 0.03) and residual disease (P = 0.02) were found to be significant independent prognostic factors, whereas age (< or = 30 years vs. 31-40 years) yielded no independent information (P = 0.36).
Epithelial ovarian cancer patients age 30 years or younger have a more favorable prognosis because of a higher rate of early stage, low grade tumors. Patients aged 31-40 years also show a more favorable disease profile and clinical outcome, although to a lesser extent, than the average ovarian cancer population. Age does not emerge as an independent prognostic factor for ovarian carcinoma in women younger than 40 years.
虽然卵巢癌在育龄组中较为罕见，但已知这些年轻患者的预后比老年患者更好。为了确定年龄是否为独立的预后因素，并调查年轻卵巢癌女性的临床病理特征和生存率，我们对一系列年龄在40岁及以下的患者进行了回顾性分析。
我们收集了1969年至1994年间在佛罗伦萨大学妇产科接受治疗的74例交界性或浸润性卵巢癌患者的数据。中位随访时间为72个月（范围11 - 288个月）。为了评估根据年龄的临床病理特征和生存差异，该系列患者被分为“非常年轻”（30岁及以下）组和“年轻”（31 - 40岁）组，分别有34例和40例患者。生存率（Kaplan-Meier法）通过对数秩检验进行比较。采用多因素分析（Cox比例风险模型）来确定每个变量对生存的独立影响。
总体5年和10年生存率分别为58.2%和46.1%。单因素分析发现几个预后因素具有显著性，包括分期（P < 0.001）、分级（P < 0.001）、残留病灶（P < 0.001）、组织学类型（P < 0.05）和年龄（≤30岁与31 - 40岁；P = 0.009）。30岁及以下患者和31 - 40岁患者的5年生存率分别为71.3%和47.1%。在前一组中，低恶性潜能肿瘤和高分化癌明显更常见（68.8%对37.5%；P = 0.01）。多因素分析中，仅分期（I期对>I期；P = 0.004）、分级（0 - 1级对2 - 3级；P = 0.03）和残留病灶（P = 0.02）被发现是显著的独立预后因素，而年龄（≤30岁与31 - 40岁）未提供独立的预后信息（P = 0.36）。
30岁及以下的上皮性卵巢癌患者预后较好，因为早期、低级别肿瘤的发生率较高。31 - 40岁的患者也显示出比一般卵巢癌人群更有利的疾病特征和临床结局，尽管程度较轻。对于40岁以下的女性，年龄并不是卵巢癌的独立预后因素。
