Clinical Outcomes among Women with Mucinous Adenocarcinoma of the Ovary.
Clinical Outcomes among Women with Mucinous Adenocarcinoma of the Ovary.
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卵巢黏液腺癌女性患者的临床疗效
DOI：
10.1159/000441791
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发表时间：
2016
影响因子：
2.1
通讯作者：
Powell M
中科院分区：
文献类型：
--
作者：
Massad LS;Gao F;Hagemann I;Powell M
由于其罕见，人们对粘液性卵巢癌的转移模式和临床行为知之甚少。对 1992 年至 2012 年某机构确诊患有纯粘液性浸润性卵巢/输卵管/腹膜癌的女性记录的回顾性审查。使用 Kaplan-Meier 方法和对数秩检验比较生存差异。 42 名患有粘液腺癌的女性中位年龄为 55 岁（范围 33-83 岁）。大多数癌症分化良好 (n = 26, 68%) 且处于 I/II 期 (n = 31, 74%)。 27 名接受淋巴结采样的女性中，有一名出现淋巴结转移；另外一名女性骨盆淋巴结复发。大多数患者在初次手术后没有可见的残留肿瘤，但在 10 名患有 III/IV 期癌症并记录有残留的女性中，有 8 名的残留肿瘤超过 2 厘米。除最后一次随访时一名女性存活外，所有复发者均因病死亡。 I/II 期病例的五年生存率为 83%，而 III/IV 期病例的五年生存率为 29%。分期是生存的有力预测因子（III/IV 期癌症女性的死亡风险比为 7.73，95% C.I. 2.33–25.66，与 I/II 期癌症女性相比，P<0.001）。粘液性卵巢癌具有独特的生物学特性，因此不需要进行淋巴结切除术进行分期，而且转移性癌症的预后较差。
Patterns of metastasis and clinical behavior of mucinous ovarian cancers are poorly understood because of their rarity. A retrospective review of records of women identified with pure mucinous invasive ovarian/tubal/peritoneal cancer 1992–2012 at one institution. Survival differences were compared using Kaplan-Meier methods with log-rank tests. Among 42 women with mucinous adenocarcinomas the median age was 55 years (range 33–83 years). Most cancers were well differentiated (n = 26, 68%) and stage I/II (n = 31, 74%). One of 27 women with sampled nodes had nodal metastasis; one additional woman recurred in a pelvic node. Most had no visible residual tumor after initial surgery, but of 10 women with stage III/IV cancer and documented residual, 8 had >2cm residual. Except for one woman alive with disease at last follow-up, all who recurred died of disease. Five-year survival was 83% for stage I/II cases but 29% among stage III/IV cases. Stage was a strong predictor of survival (hazard ratio of death among women with stage III/IV cancer 7.73, 95% C.I. 2.33–25.66, P<0.001 vs women with stage I/II cancer). Mucinous ovarian cancers have a distinct biology, such that lymphadenectomy for staging is unnecessary and metastatic cancers have poor prognosis.