Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis
Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis
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DOI：
10.1245/s10434-014-4319-9
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发表时间：
2015-08-01
影响因子：
3.7
通讯作者：
Song, Yong Sang
中科院分区：
文献类型：
--
作者：
Kim, Hee Seung;Kim, Min A.;Song, Yong Sang
尽管卵巢透明细胞癌（OCCC）与子宫内膜异位症之间存在关系，但子宫内膜异位症是否影响卵巢透明细胞癌（OCCC）的预后仍存在争议。为探讨子宫内膜异位症对卵巢癌预后的影响，本研究采用双中心队列研究和荟萃分析方法，回顾了1997 - 2012年两个三级医疗中心109例发生或未发生卵巢癌的子宫内膜异位症患者的临床病理资料。比较两组患者的肿瘤缓解率和生存率。为了进一步评估，我们检索了PubMed、EmBase和科克伦图书馆，并对1996年3月至2014年5月发表的10项队列研究进行了荟萃分析，包括当前的队列研究，子宫内膜异位症引起的OCCC患者和非子宫内膜异位症患者的完全缓解率没有差异（77.5% vs. 87.3%; P = 0.444）。早期疾病和最佳减瘤手术是降低不完全缓解风险的唯一独立因素（校正比值比分别为0.203和0.038; 95%置信区间[CI]分别为0.045-0.920和0.006-0.226）。无进展生存期（PFS）和总生存期（OS）在两组之间没有差异。早期疾病和最佳减积手术是改善PFS的唯一有利因素（校正的风险比[HR]分别为0.216和0.332; 95% CI分别为0.099-0.469和0.150-0.732）和OS（校正HR分别为0.099和0.339; 95% CI分别为0.039-0.252和0.141-0.815）。此外，初步和亚组荟萃分析显示，子宫内膜异位症对OCCC患者的PFS或OS没有影响，子宫内膜异位症可能不影响OCCC患者的肿瘤反应或预后。
Whether endometriosis affects the prognosis of ovarian clear cell carcinoma (OCCC) remains controversial despite the relationship between OCCC and endometriosis. A two-center cohort study and meta-analysis were performed to investigate the effect of endometriosis on the prognosis of OCCC.The study reviewed the clinicopathologic data of 109 patients with OCCC arising (n = 47) or not arising (n = 62) in endometriosis between 1997 and 2012 at two tertiary medical centers. Tumor response and survival were compared between the two groups. For further evaluation, PubMed, EmBase, and the Cochrane Library were searched, and a meta-analysis was conducted using 10 cohort studies published from March 1996 to May 2014, including the current cohort study.Complete response did not differ between the patients with OCCC arising in endometriosis and those without endometriosis (77.5 vs. 87.3 %; P = 0.444). Early-stage disease and optimal debulking surgery were the only independent factors that reduced the risk of noncomplete response (adjusted odds ratios 0.203 and 0.038; 95 % confidence intervals [CIs] 0.045-0.920 and 0.006-0.226, respectively). Progression-free survival (PFS) and overall survival (OS) did not differ between the two groups. Early-stage disease and optimal debulking surgery were the only favorable factors that improved PFS (adjusted hazard ratios [HRs] 0.216 and 0.332; 95 % CIs 0.099-0.469 and 0.150-0.732, respectively) and OS (adjusted HRs 0.099 and 0.339; 95 % CIs 0.039-0.252 and 0.141-0.815, respectively). Furthermore, crude and subgroup meta-analyses showed no effect of endometriosis on PFS or OS in OCCC patients.Endometriosis may not affect the tumor response or the prognosis of OCCC patients.