Effect of tumor type on response to adjuvant platinum-based chemotherapy and prognosis in patients with stage II-IV epithelial ovarian carcinoma.

IF 1.2 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Ginekologia polska Pub Date : 2024-01-01 Epub Date: 2023-09-05 DOI:10.5603/gpl.94024
Gizem Aktemur, Cigdem Kilic, Fatih Kilic, Mehmet Ünsal, Gunsu Kimyon Comert, Taner Turan
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引用次数: 0

Abstract

Objectives: To evaluate the effect of histological subtype on oncological outcome and adjuvant platinum-based chemotherapy response in patients with epithelial ovarian cancer (EOC).

Material and methods: The study group was created with stage II-IV EOC patients. Progression-free survival (PFS) and disease-specific survival (DSS) estimates were determined by using the Kaplan-Meier method. The log-rank test and cox proportional hazards model were performed.

Results: A total 396 patients were included the study. Tumor type was serous in 332 (83.8%). Two hundred and thirty-one patients (58.3%) had maximal cytoreduction. Three hundred and twenty-seven (82.6%) patients received complete clinical response. Refractory disease was present in 69 (17.4%) patients. In patients with complete clinical response, 183 (56%) patients recurred. Five-year PFS was 32% in serous group and 31% in non-serous group (p = 0.755). Five-year DSS was 78% in serous group and 87% in non-serous group (p = 0.084). On multivariate analysis, recurrence rates 1.959 times (95% CI: 1.224-3.085; p = 0.004), death rates 2.624 times (95% CI: 1.328-5.185; p = 0.005) higher in patients with optimal cytoreduction than patients with maximal cytoreduction, respectively.

Conclusions: Although the rate of maximal cytoreduction was higher in patients with non-serous tumor type, the rate of refractory disease was higher after adjuvant chemotherapy. However, the recurrence rate was higher in serous tumor type. Survival rates were similar in serous and non-serous tumor types. Maximal cytoreduction was an independent predictor factor for survival. Maximal cytoreduction should be the main target in EOC.

肿瘤类型对 II-IV 期上皮性卵巢癌患者辅助铂类化疗反应和预后的影响。
研究目的评估组织学亚型对上皮性卵巢癌(EOC)患者的肿瘤预后和铂类辅助化疗反应的影响:研究对象为II-IV期EOC患者。采用 Kaplan-Meier 法确定无进展生存期(PFS)和疾病特异性生存期(DSS)的估计值。采用对数秩检验(log-rank test)和柯克斯比例危险模型(cox proportional hazards model):共有 396 例患者纳入研究。332例(83.8%)患者的肿瘤类型为浆液性。231名患者(58.3%)进行了最大程度的细胞减灭术。327名患者(82.6%)获得了完全临床反应。69名患者(17.4%)出现了难治性疾病。在完全临床应答的患者中,有183人(56%)复发。浆液性组五年生存率为 32%,非浆液性组为 31%(P = 0.755)。浆液性组五年 DSS 为 78%,非浆液性组为 87%(P = 0.084)。多变量分析显示,最佳细胞减灭术患者的复发率是最大细胞减灭术患者的1.959倍(95% CI:1.224-3.085;p = 0.004),死亡率是最大细胞减灭术患者的2.624倍(95% CI:1.328-5.185;p = 0.005):尽管非肉质肿瘤类型患者的最大囊肿剥除率更高,但辅助化疗后的难治性疾病率更高。然而,浆液性肿瘤的复发率更高。浆液性肿瘤和非浆液性肿瘤的生存率相似。最大程度的细胞减灭术是生存率的独立预测因素。最大程度的细胞减灭术应成为EOC的主要治疗目标。
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来源期刊
Ginekologia polska
Ginekologia polska OBSTETRICS & GYNECOLOGY-
CiteScore
2.00
自引率
15.40%
发文量
317
审稿时长
4-8 weeks
期刊介绍: Ginekologia Polska’ is a monthly medical journal published in Polish and English language. ‘Ginekologia Polska’ will accept submissions relating to any aspect of gynaecology, obstetrics and areas directly related. ‘Ginekologia Polska’ publishes original contributions, comparative works, case studies, letters to the editor and many other categories of articles.
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