新辅助化疗在晚期透明细胞卵巢癌中的作用：一项GCIG多机构回顾性队列研究

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-09-25 DOI:10.1016/j.ygyno.2025.09.009

Sahana Somasegar , Jiaqi Zhang , Christina Fotopoulou , Diletta Fumagalli , Jalid Sehouli , Charlie Gourley , Michael Churchman , Elena Ioana Braicu , Amer Karam

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引用次数: 0

摘要

目的评价新辅助化疗（NACT）与原发性细胞减少手术（PCS）对晚期透明细胞卵巢癌（OCCC）患者手术结局和生存期的影响。方法对2010年至2024年间在4个三级癌症中心接受FIGO iii期ib - ivb OCCC治疗的133例患者进行了多机构回顾性队列研究。患者分别接受NACT +间隔减容手术（n = 21）或PCS +辅助化疗（n = 112）。统计分析包括Wilcoxon秩和、卡方/费雪精确检验、Kaplan-Meier估计和log-rank检验。结果基线特征相似，但NACT患者的ECOG表现状况较差（p = 0.019）。48%的NACT患者和67%的PCS患者实现了完全切除（RD0）（p = 0.21）。NACT组的中位PFS为11.0个月，PCS组为12.4个月（p = 0.55）；中位OS分别为23.0和27.4个月（p = 0.15）。与RD≤10 mm相比，细胞减少至RD≤10 mm与OS改善相关（27.4个月vs 10.0个月，p = 0.037），但与PFS改善无关。与RD >； 0患者相比，RD0患者的OS和PFS在数值上更长，尽管没有统计学意义。结论在这个多机构队列中，无论采用何种治疗方法，晚期OCCC都与较差的生存率相关。与PCS相比，NACT没有显著提高可切除性或生存率。然而，最大的手术努力和达到RD≤10 mm或RD0与更好的结果相关，强调了细胞减少对预后的重要性和迫切需要进行组织学特异性试验。

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The role of neoadjuvant chemotherapy in advanced-stage clear cell ovarian cancer: A GCIG multi-institutional retrospective cohort study

Objective

To evaluate the impact of neoadjuvant chemotherapy (NACT) versus primary cytoreductive surgery (PCS) on surgical outcomes and survival in in patients with advanced clear cell ovarian cancer (OCCC).

Methods

We conducted a multi-institutional retrospective cohort study of 133 patients with FIGO stage IIIB–IVB OCCC treated between 2010 and 2024 at four tertiary cancer centers. Patients received either NACT followed by interval debulking surgery (n = 21) or PCS followed by adjuvant chemotherapy (n = 112). Statistical analyses included Wilcoxon rank-sum, Chi-square/Fisher's exact test, Kaplan–Meier estimates, and log-rank test.

Results

Baseline characteristics were similar, although NACT patients had worse ECOG performance status (p = 0.019). Complete resection (RD0) was achieved in 48 % of NACT patients and 67 % of PCS patients (p = 0.21). Median PFS was 11.0 months with NACT and 12.4 months with PCS (p = 0.55); median OS was 23.0 and 27.4 months, respectively (p = 0.15). Cytoreduction to RD ≤10 mm was associated with improved OS compared with RD >10 mm (27.4 vs 10.0 months, p = 0.037), but not with improved PFS. Patients with RD0 had numerically longer OS and PFS compared to those with RD > 0, though not statistically significant.

Conclusion

In this multi-institutional cohort, advanced OCCC was associated with poor survival regardless of treatment approach. NACT did not significantly improve resectability or survival compared with PCS. However, maximal surgical effort and achieving RD ≤10 mm or RD0 were associated with better outcomes, underscoring the prognostic importance of cytoreduction and the urgent need for histology-specific trials.

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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