Prognostic factors for stage III epithelial ovarian cancer treated with intraperitoneal chemotherapy: a Gynecologic Oncology Group study.
Prognostic factors for stage III epithelial ovarian cancer treated with intraperitoneal chemotherapy: a Gynecologic Oncology Group study.
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DOI：
10.1016/j.ygyno.2013.04.001
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发表时间：
2013-07
影响因子：
4.7
通讯作者：
Walker JL
中科院分区：
文献类型：
--
作者：
Landrum LM;Java J;Mathews CA;Lanneau GS Jr;Copeland LJ;Armstrong DK;Walker JL
利用合作组临床试验的辅助数据，确定腹膜内化疗（IP）治疗的肿瘤患者生存的预后因素。数据来自428例III期卵巢癌患者，这些患者接受了最佳手术细胞减少（<1 cm），随后接受了IP紫杉醇/铂化疗。主要终点为无进展生存期（PFS）和总生存期（OS）。在Cox比例风险回归模型中纳入潜在的预后变量。进行多变量分析以确定独立的预后因素。中位PFS为24.9个月（95% CI, 23.0-29.2），中位OS为61.8个月（95% CI, 55.5 - 69.8）。PFS的预测因子为组织学、手术分期和残留病变。年龄、组织学和残留疾病是OS的预后因素。在淋巴结状态为阳性、阴性或未知的患者之间，死亡或进展的风险比没有差异。对于接受IP化疗的患者（n = 428）， 36%的患者无残留疾病，中位PFS为43.2个月（95% CI 32.5-60.4），中位OS为110个月（95% CI 60.0-161.3）。年龄、组织学和残留病变程度是在最佳细胞减少后接受IP化疗的III期患者发生OS的预测因素。原发性手术后无残留疾病的患者接受辅助铂基IP化疗，其生存率超过以往在该人群中所见的任何生存率。
To determine prognostic factors for survival inovarian cancer patients treated with intraperitoneal (IP) chemotherapy using ancillary data from cooperative group clinical trials. Data were collected from 428 patients with stage III ovarian cancer who underwent optimal surgical cytoreduction (<1 cm) followed by IP paclitaxel/platinum chemotherapy. Primary endpoints were progression free survival (PFS) and overall survival (OS). Potential prognostic variables were included in Cox proportional hazard regression models. Multivariate analysis was conducted to identify independent prognostic factors. Median PFS was 24.9 months (95% CI, 23.0–29.2) and median OS was 61.8 months (95% CI, 55.5– 69.8). Predictors for PFS were histology, surgical stage and residual disease. Age, histology, and residual disease were prognostic for OS. There were no differences in the hazard ratio for death or progression between patients with positive, negative, or unknown lymph node status. For patients receiving IP chemotherapy (n = 428), 36% of patients had no residual disease with median PFS of 43.2 months (95% CI 32.5–60.4) and median OS of 110 months (95% CI, 60.0–161.3). Age, histology, and extent of residual disease were predictors of OS in stage III patients treated with IP chemotherapy following optimal cytoreduction. Patients with no residual disease following primary surgery that are treated with adjuvant platinum based IP chemotherapy have survival measures that exceed any rates previously seen in this population.