Characteristic and prognostic implication of venous thromboembolism in ovarian clear cell carcinoma: a 12-year retrospective study.
Characteristic and prognostic implication of venous thromboembolism in ovarian clear cell carcinoma: a 12-year retrospective study.
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卵巢透明细胞癌静脉血栓栓塞的特征和预后意义：一项 12 年回顾性研究
DOI：
10.1371/journal.pone.0121818
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Shen K
中科院分区：
文献类型：
--
作者：
Ye S;Yang J;Cao D;Bai H;Huang H;Wu M;Chen J;You Y;Lang J;Shen K
目的探讨中国卵巢透明细胞癌（CCC）患者静脉血栓栓塞（VTE）的特点及预后意义。方法通过检索我们的机构卵巢CCC数据库，对2000 - 2012年的所有病例进行鉴定。对医疗文件进行了全面审查，以收集相关数据。生存率分析采用Kaplan-Meier模型和Cox回归。结果227例患者中，33例（14.5%）发生静脉血栓栓塞事件。VTE组与非VTE组患者在年龄、血清癌抗原125、肿瘤大小等方面无显著差异。无静脉血栓栓塞患者的最佳细胞减少率（70.1%）高于有静脉血栓栓塞患者（51.5%）。静脉血栓栓塞（VTE）事件更可能发生在首发（36.4%）和复发（33.3%），其次是辅助化疗期（18.2%）。VTE在晚期疾病患者中比早期疾病患者更常见（P=0.003），而肺栓塞（PE）在晚期疾病患者中的发生率是早期疾病患者的10倍（8.6%对0.8%，P= 0.012）。晚期患者往往在近端静脉有血栓。经尸检证实，2例患者死于PE。与没有静脉血栓栓塞的患者相比，静脉血栓栓塞患者的生存期缩短（中位总生存期54个月对140个月，P<0.001；中位无进展生存期17个月对43个月，P<0.001）。总体而言，14.5%的卵巢CCC患者发生过静脉血栓栓塞，主要发生在癌症诊断前或复发时。静脉血栓栓塞对患者生存产生不利影响。
Purpose To profile the characteristic and prognostic implications of venous thromboembolism (VTE) in Chinese ovarian clear cell carcinoma (CCC) patients. Methods We identified all of the cases between 2000 and 2012 by searching our institutional Ovarian CCC Database. A comprehensive review of the medical documentation was performed to collect relevant data. Kaplan-Meier models and Cox regression were employed for survival analysis. Results Of the 227 patients, 33 (14.5%) experienced VTE events. There was no significant difference between VTE and non-VTE group patients regarding age, serum cancer antigen 125 or tumor size. The optimal cytoreduction rate was higher in patients without VTE (70.1%) than in those with VTE (51.5%). VTE events were more likely to occur at presentation (36.4%) and recurrence (33.3%), followed by an adjuvant chemotherapy period (18.2%). VTE was more common in patients with advanced-stage disease than those with early-stage disease (P=0.003), whereas pulmonary embolism (PE) was 10-fold as common in advanced-stage disease as in early-stage disease (8.6% vs. 0.8%, P = 0.012). Patients with advanced disease tended to have thrombi in the proximal veins. Two patients died of PE, as confirmed by autopsy. Patients with VTE had reduced survival compared to those without VTE (median overall survival 54 vs. 140 months, P<0.001; median progression-free survival 17 vs. 43 months, P<0.001). Conclusions Overall, 14.5% of the patients with ovarian CCC experienced VTE, mainly before their cancer diagnosis or at a time of recurrence. VTE adversely impacted patient survival.
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