Gershenson D M, Silva E G, Tortolero-Luna G, Levenback C, Morris M, Tornos C
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Cancer. 1998 Nov 15;83(10):2157-63. doi: 10.1002/(sici)1097-0142(19981115)83:10<2157::aid-cncr14>3.0.co;2-d.
The authors conducted this study to update their experience with patients who have ovarian serous borderline tumors with noninvasive peritoneal implants, with the objectives of gaining additional insight into the biologic behavior of these tumors and understanding better the effects of postoperative treatment.
Seventy-three patients who had ovarian serous borderline tumors with noninvasive peritoneal implants were identified in a retrospective review. Major end points selected for analysis were surgicopathologic response, time to relapse, type of relapse, progression free survival, and overall survival. Univariate and multivariate regression analyses were also performed.
The median follow-up time was 10.3 years. Of 20 patients with macroscopic residual disease at completion of initial surgery who subsequently underwent second-look surgery, 3 (15%) had a response to chemotherapy. Twenty-two of 73 patients (30%) either developed progressive disease or had a relapse. The median time from the date of diagnosis to relapse was 7.1 years. Tissue was available from 20 of the 22 patients who had a relapse; 14 (70%) had invasive low grade serous carcinomas, and 6 (30%) had recurrent borderline tumors. Age was the only factor studied that had a significant influence on survival (P = 0.03). In both univariate and multivariate proportional hazards models, age and residual disease were found to be of borderline significance in predicting cancer specific survival.
Approximately 30% of patients who have ovarian serous borderline tumors with noninvasive peritoneal implants will develop progressive or recurrent tumors, most commonly serous carcinomas. The presence of macroscopic residual disease appears to be a predictor of disease free survival. In this study, however, the authors were unable to elucidate the role of postoperative therapy or determine criteria for selecting patients for such therapy.
作者开展本研究以更新其对患有卵巢浆液性交界性肿瘤伴非侵袭性腹膜种植患者的治疗经验，目的是进一步深入了解这些肿瘤的生物学行为，并更好地理解术后治疗的效果。
通过回顾性分析确定了73例患有卵巢浆液性交界性肿瘤伴非侵袭性腹膜种植的患者。选择用于分析的主要终点为手术病理反应、复发时间、复发类型、无进展生存期和总生存期。还进行了单因素和多因素回归分析。
中位随访时间为10.3年。在初次手术结束时存在肉眼可见残留病灶且随后接受二次探查手术的20例患者中，3例（15%）对化疗有反应。73例患者中有22例（30%）出现疾病进展或复发。从诊断日期到复发的中位时间为7.1年。在22例复发患者中，有20例可获得组织样本；14例（70%）为侵袭性低级别浆液性癌，6例（30%）为复发性交界性肿瘤。年龄是所研究的唯一对生存有显著影响的因素（P = 0.03）。在单因素和多因素比例风险模型中，年龄和残留病灶在预测癌症特异性生存方面均具有临界显著性。
约30%患有卵巢浆液性交界性肿瘤伴非侵袭性腹膜种植的患者会出现肿瘤进展或复发，最常见的是浆液性癌。肉眼可见残留病灶的存在似乎是无病生存的一个预测指标。然而，在本研究中，作者未能阐明术后治疗的作用，也未能确定选择患者进行此类治疗的标准。
