Impact of surgical complexity on disease-free survival and overall survival in newly diagnosed advanced ovarian cancer.

IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Víctor Lago, Blanca Novillo-Del Álamo, Marta Arnáez, Iria Rey, Pablo Padilla-Iserte, Luis Matute, Marta Gurrea, Santiago Domingo
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引用次数: 0

Abstract

Objective: Ovarian cancer surgery and the complexity of the procedure may be measured with the standardized Aletti score. The main objective of this study was to establish the influence of surgical complexity using the Aletti score on disease-free survival and overall survival.

Methods: A retrospective observational study was conducted in a reference gynecologic oncology department, including advanced ovarian cancer patients, newly diagnosed who underwent a primary debulking surgery or interval debulking surgery between January 2010 and December 2019 (stage IIB-IV International Federation of Gynecology and Obstetrics classification), and epithelial histology. Incomplete medical records, loss to follow-up patients, and borderline histologies were excluded. Survival analysis and multivariate analysis were performed.

Results: A total of 399 patients were included in the study. Regarding Aletti score complexity, no differences were observed in disease-free survival (median: 25 vs 24 months, p = .5) or overall survival (median: 56 vs 49 months, p = .6). Complete cytoreduction was associated with better disease-free survival (median: complete 26 vs optimal 14 vs sub-optimal 9 months, p < .0001) and overall survival (p < .0001). Furthermore, primary debulking surgery showed statistically better disease-free survival (median: 25 vs 16 months, p < .0001) and overall survival (median: 72 vs 38 months, p < .0001) compared to interval debulking surgery. The multivariable analysis showed that disease-free survival, overall survival, International Federation of Gynecology and Obstetrics classification, CA125 level at diagnosis, cytoreduction classification achieved after surgery, and the Clavien-Dindo complications did not significantly associate with the Aletti score.

Conclusions: Disease-free survival and overall survival were not influenced by the surgical complexity in patients undergoing cytoreduction after the first diagnosis of advanced ovarian cancer. A higher Aletti score was not associated with a higher rate of complications.

手术复杂性对新诊断晚期卵巢癌患者无病生存期和总生存期的影响。
目的:用标准化的Aletti评分来衡量卵巢癌手术及其复杂程度。本研究的主要目的是利用Aletti评分确定手术复杂性对无病生存期和总生存期的影响。方法:在参考妇科肿瘤科进行回顾性观察研究,包括2010年1月至2019年12月期间新诊断并接受过原发性降压手术或间歇降压手术的晚期卵巢癌患者(IIB-IV期国际妇产科联合会分类),以及上皮组织学。排除了病历不完整、随访患者丢失和边缘性组织学。进行生存分析和多变量分析。结果:共纳入399例患者。关于Aletti评分复杂性,无病生存期(中位数:25个月vs 24个月,p = 0.5)或总生存期(中位数:56个月vs 49个月,p = 0.6)没有观察到差异。完全细胞减少与更好的无病生存期(中位数:完全26个月vs最佳14个月vs次最佳9个月,p < 0.0001)和总生存期(p < 0.0001)相关。此外,与间隔减容手术相比,初次减容手术在统计学上显示了更好的无病生存期(中位数:25个月vs 16个月,p < 0.0001)和总生存期(中位数:72个月vs 38个月,p < 0.0001)。多变量分析显示,无病生存率、总生存率、国际妇产联合会分级、诊断时CA125水平、术后细胞减少分级、Clavien-Dindo并发症与Aletti评分无显著相关性。结论:首次诊断为晚期卵巢癌后行细胞减少术的患者无病生存期和总生存期不受手术复杂度的影响。较高的Aletti评分与较高的并发症发生率无关。
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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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