恶性腹膜细胞学对子宫内膜癌预后意义的前瞻性评估：NRG肿瘤/妇科肿瘤组对GOG-210方案的研究

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-09-03 DOI:10.1016/j.ygyno.2025.08.029

Koji Matsuo , Danielle M. Enserro , Jason D. Wright , Lynda D. Roman , Matthew A. Powell , David S. Miller , Christa I. Nagel , Premal H. Thaker , Robert S. Mannel , Ashley R. Stuckey , Saketh R. Guntupalli , Paniti Sukumvanich , Melissa A. Geller , Roberto Vargas , Gottfried E. Konecny , David P. Warshal , Krishnansu S. Tewari , Nick M. Spirtos , Bhavana Pothuri , William T. Creasman , David G. Mutch

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引用次数: 0

摘要

目的探讨恶性腹膜细胞学检查与子宫内膜癌患者生存结局的关系。方法对NRG肿瘤学/妇科肿瘤学组在GOG-210方案下前瞻性收集的外科病理资料进行辅助分析。研究人群包括2003年至2011年期间2383例I-III期子宫内膜癌患者。暴露于腹膜细胞学状态：恶性腹膜细胞学（n = 215）或阴性腹膜细胞学（n = 2168）。主要结局指标为无复发生存期和总生存期。倾向评分反概率治疗加权来平衡基线临床病理特征，然后调整辅助治疗。结果恶性腹膜细胞学检查与阴性腹膜细胞学检查相比，复发风险增加32%(5年发生率，72%对77%，风险比1.32,95%可信区间1.03 ~ 1.69,P = 0.028)，全因死亡风险增加37%（78%对83%，风险比1.37,95%可信区间1.06 ~ 1.78,P = 0.018）。在控制辅助治疗后，恶性腹膜细胞学与生存率的相关性在无复发生存率（调整风险比1.16,95%可信区间0.90 ~ 1.50,P = 0.24）和总生存率（调整风险比1.22,95%可信区间0.93 ~ 1.60,P = 0.16）均减弱，但无统计学意义。腹膜细胞学状况与辅助治疗类型可能对总生存有相互作用，而恶性腹膜细胞学与放疗作为辅助治疗时总生存降低相关，而化疗不相关（p相互作用= 0.059）。结论：这项前瞻性评估的结果表明，恶性腹膜细胞学检查是一个预后因素，如果有的话，它与子宫内膜癌生存率的适度降低有关。

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Prospective assessment of prognostic significance of malignant peritoneal cytology in endometrial cancer: An NRG Oncology / Gynecologic Oncology Group study on GOG-210 protocol

Objective

To examine the association between malignant peritoneal cytology and survival outcomes in endometrial cancer.

Methods

This was an ancillary analysis of prospectively collected surgical-pathological data in the NRG Oncology / Gynecologic Oncology Group study on GOG-210 protocol. The study population included 2383 patients with stage I-III endometrial cancer from 2003 to 2011. Exposure was peritoneal cytology status: malignant peritoneal cytology (n = 215) or negative peritoneal cytology (n = 2168). Main outcome measures were recurrence-free survival and overall survival. Propensity score inverse probability treatment weighting was performed to balance the baseline clinico-pathological characteristics, followed by adjustment for adjuvant therapy.

Results

Malignant peritoneal cytology was associated with a 32% increased risk of recurrence (5-year rates, 72% versus 77%, hazard ratio 1.32, 95% confidence interval 1.03 to 1.69, P = 0.028) and 37% increased risk of all-cause mortality (78% versus 83%, hazard ratio 1.37, 95% confidence interval 1.06 to 1.78, P = 0.018) compared to negative peritoneal cytology. When controlling for adjuvant therapy, the association between malignant peritoneal cytology and survival was attenuated for both recurrence-free survival (adjusted-hazard ratio 1.16, 95% confidence interval 0.90 to 1.50, P = 0.24) and overall survival (adjusted-hazard ratio 1.22, 95% confidence interval 0.93 to 1.60, P = 0.16) without statistical significance. Peritoneal cytology status and adjuvant therapy type had a possible interaction on overall survival, and malignant peritoneal cytology was associated with decreased overall survival when radiotherapy was received as adjuvant therapy but not when chemotherapy was utilized (P-interaction = 0.059).

Conclusion

The results of this prospective assessment suggest that malignant peritoneal cytology is a prognostic factor, if any, associated with a modest decrease in survival for endometrial cancer.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy