Prognostic factors for stage III epithelial ovarian cancer: A Gynecologic Oncology Group Study
Prognostic factors for stage III epithelial ovarian cancer: A Gynecologic Oncology Group Study
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DOI：
10.1200/jco.2006.10.2517
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发表时间：
2007-08-20
影响因子：
45.3
通讯作者：
McGuire, William P.
中科院分区：
文献类型：
--
作者：
Winter, William E., III;Maxwell, G. Larry;McGuire, William P.
目的由于样本量小和研究人群的异质性，晚期上皮性卵巢癌（EOC）预后因素的研究结果一直被报道。本研究的目的是确定接受类似治疗的晚期EOC女性人群预后不良的预测因素。患者和方法回顾性审查了1，895名国际妇产科联合会III期EOC患者的人口统计学、病理学、治疗和结局数据，这些患者接受了初次手术，随后进行了六个周期的静脉铂/紫杉醇治疗。采用比例风险模型评估预后因素与无进展生存期（PFS）和总生存期（OS）的相关性。（HR = 1.06; 95% CI，1.02 - 1.11，每10年增加一次）和死亡（HR = 1.12; 95% CI，1.06 - 1.18）。与浆液性癌相比，粘液性或透明细胞组织学与更差的PFS和OS相关。体力状态（PS）1或2的患者复发风险高于PS 0（HR = 1.12; 95% CI，1.01 - 1.24）。与显微镜下残留病灶的患者相比，残留病灶0.1 ~ 1.0cm和> 1.0cm的患者复发风险增加（HR = 1.96; 95% CI，1.70 - 2.26; HR = 2.36; 95% CI，2.04 - 2.73）和死亡（HR = 2.11; 95%CI，1.78 ~ 2.49; P <0.001; HR = 2.47; 95%CI，2.09 ~ 2.92）。结论年龄、PS、肿瘤组织学和残留肿瘤体积是III期EOC患者预后的独立预测因子。这些数据可用于识别预后不良的患者，并设计未来定制的随机临床试验。
PurposeConflicting results on prognostic factors for advanced epithelial ovarian cancer ( EOC) have been reported because of small sample size and heterogeneity of study population. The purpose of this study was to identify factors predictive of poor prognosis in a similarly treated population of women with advanced EOC.Patients and MethodsA retrospective review of demographic, pathologic, treatment, and outcome data from 1,895 patients with International Federation of Gynecology and Obstetrics stage III EOC who had undergone primary surgery followed by six cycles of intravenous platinum/paclitaxel was conducted. A proportional hazards model was used to assess the association of prognostic factors with progression-free survival ( PFS) and overall survival ( OS).ResultsIncreasing age was associated with increased risks for disease progression ( HR = 1.06; 95% CI, 1.02 to 1.11 for an increase every 10 years) and death ( HR = 1.12; 95% CI, 1.06 to 1.18). Mucinous or clear-cell histology was associated with a worse PFS and OS compared with serous carcinomas. Patients with performance status ( PS) 1 or 2 were at an increased risk for recurrence compared with PS 0 ( HR = 1.12; 95% CI, 1.01 to 1.24). Compared with patients with microscopic residual disease, patients with 0.1 to 1.0 cm and > 1.0 cm residual disease had an increased risk of recurrence ( HR = 1.96; 95% CI, 1.70 to 2.26; and HR = 2.36; 95% CI, 2.04 to 2.73, respectively) and death ( HR = 2.11; 95% CI, 1.78 to 2.49; P < .001; and HR = 2.47; 95% CI, 2.09 to 2.92, respectively).ConclusionAge, PS, tumor histology, and residual tumor volume were independent predictors of prognosis in patients with stage III EOC. These data can be used to identify patients with poor prognosis and to design future tailored randomized clinical trials.