Hoskins P, Tu D, James K, Pater J, Koski B
Vancouver Cancer Centre, British Columbia Cancer Agency and University of British Columbia, Vancouver, British Columbia, V5Z 4E6, Canada.
Gynecol Oncol. 1998 Aug;70(2):224-30. doi: 10.1006/gyno.1998.5074.
To identify factors predictive of overall survival after first relapse or primary progression in patients with advanced epithelial ovarian cancer.
"Tree-structured prediction of survival for censored survival data" was used to identify the independent prognostic factors in the test group (n = 352) who were the patients from the previously reported Canadian OV.8 trial. A prognostic model was developed using these factors and subjected to validation in the Canadian OV.4 trial cohort (n = 282).
Based upon three factors, time from diagnosis to first recurrence or progression, tumor grade at diagnosis, and ECOG performance status at original diagnosis, three groups of patients were identified. These were labeled as good, intermediate, and poor prognosis with median survivals post relapse of 18 (12), 6 (5), and 1 (2) months, respectively. The figure in parentheses is the survival in the validation cohort.
These prognostic groupings enable us to recommend second-line treatment more logically. The patients in the poor prognosis group have such a limited survival that cancer shrinking therapy should not routinely be offered. In addition the use of the individual predictive factors as stratification factors will help to avoid erroneous conclusions about treatment efficacy.
确定晚期上皮性卵巢癌患者首次复发或原发进展后总生存的预测因素。
采用“截尾生存数据的生存树结构预测”来确定测试组（n = 352）中的独立预后因素，该测试组患者来自先前报道的加拿大OV.8试验。利用这些因素建立了一个预后模型，并在加拿大OV.4试验队列（n = 282）中进行验证。
基于从诊断到首次复发或进展的时间、诊断时的肿瘤分级以及初次诊断时的东部肿瘤协作组（ECOG）体能状态这三个因素，确定了三组患者。这些患者被标记为预后良好、中等和不良，复发后的中位生存期分别为18（12）个月、6（5）个月和1（2）个月。括号内的数字是验证队列中的生存期。
这些预后分组使我们能够更合理地推荐二线治疗。预后不良组患者的生存期有限，不应常规提供癌症缩小治疗。此外，将个体预测因素用作分层因素将有助于避免关于治疗疗效的错误结论。
