Role of histological type on surgical outcome and survival following radical primary tumour debulking of epithelial ovarian, fallopian tube and peritoneal cancers.
Role of histological type on surgical outcome and survival following radical primary tumour debulking of epithelial ovarian, fallopian tube and peritoneal cancers.
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组织学类型对上皮卵巢，输卵管和腹膜癌的自由基原发性肿瘤后的手术结局和存活的作用。
DOI：
10.1038/bjc.2011.455
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发表时间：
2011-12-06
影响因子：
8.8
通讯作者：
Fotopoulou, C.
中科院分区：
文献类型：
--
作者：
Braicu, E-I;Sehouli, J.;Richter, R.;Pietzner, K.;Denkert, C.;Fotopoulou, C.
目的：评估卵巢原发上皮性癌、输卵管癌或腹膜癌(EOC)患者卵巢肿瘤发生的两种组织学类型的临床影响。将本院2000年9月至2010年8月原发肿瘤摘除后的632例卵巢上皮性肿瘤患者分为两组：I型肿瘤100例(15.8%)，包括低级别浆液性、低级别子宫内膜样癌、透明细胞癌、粘液性癌和移行细胞癌；II型肿瘤(532例)，由高级别浆液性、高级别子宫内膜样癌、未分化和恶性混合中胚层肿瘤组成。Kaplan-Meier和Logistic/Cox回归分析评估组织学类型对手术结果和生存的影响。II型患者的晚期疾病发生率(FIGO III/IV)显著高于I型患者(分别为79.8%和38%；P<；0.001)。在II型患者中位CA125值(438vs93 U ml−1；P=0.001)、手术时间(258vs237 min；P=0.001)和肿瘤不完全切除率(34.4%vs15%P&t；0.001)显著高于II型患者(P<；0.001)。I型肿瘤患者的总体生存率(P=0.021)和无进展生存率(P=0.003)也显著较高。多变量分析表明，术后肿瘤残留物、阳性淋巴结和盆腔外扩散是生存的独立预测因素，但未能显示任何组织学类型的预后意义。与II型患者相比，I型卵巢癌患者似乎出现在早期阶段，其存活率显著高于II型患者，且手术结果更理想。然而，在晚期，组织学作为一个独立的预测指标失去了意义。
To assess the clinical impact of the two histological types as designated in the proposed model for ovarian tumourigenesis in primary epithelial ovarian, fallopian tube or peritoneal cancer (EOC) patients. All consecutive EOC patients (n=632) after primary tumour debulking in our institution (09/2000–08/2010) were classified into one of two groups: type I tumours (n=100; 15.8%) composed of low-grade serous, low-grade endometrioid, clear cell, mucinous and transitional carcinomas; and Type II tumours (n=532; 84.1%) composed of high-grade serous, high-grade endometrioid, undifferentiated and malignant mixed-mesodermal tumours. Kaplan–Meier and logistic/Cox-regression analyses were performed to assess the impact of histological type on surgical outcome and survival. Type II patients had a significantly higher incidence of advanced disease (FIGO III/IV) than Type I patients (79.8% vs 38%, respectively; P<0.001). Median CA125 values (438 vs 93 U ml−1; P=0.001); operative time (258 vs 237 min; P=0.001); and incidence of incomplete tumour resection (34.4% vs 15% P<0.001) were significantly higher in patients with Type II. During a mean follow-up time of 23 months (range: 1–106), 17% of patients with type I vs 34.8% of patients with type II tumours relapsed and/or died (P<0.001). Overall survival (P=0.021) and progression-free survival (P=0.003) were also significantly higher in patients with type I tumours. Multivariate analysis, while identifying postoperative tumour residuals, positive lymph nodes and extrapelvic dissemination as independent predictors of survival, failed to demonstrate any prognostic significance of histological type. Type I EOC patients appear to present at earlier stages have significantly higher survival and more optimal surgical outcome compared with type II patients. However, in advanced stages, histology loses significance as an independent prognosticator.
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DOI：
10.1097/pas.0b013e3181cf3d79
发表时间：
2010-03
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Kurman RJ;Shih IeM
通讯作者：
Shih IeM
DOI：
10.1111/igc.0b013e3181f15714
发表时间：
2010-11-01
影响因子：
4.8
作者：
Sehouli, Jalid;Savvatis, Konstantinos;Fotopoulou, Christina
通讯作者：
Fotopoulou, Christina
影响因子：
4.7
作者：
Goff, BA;delaCuesta, RS;Fuller, AF
通讯作者：
Fuller, AF
影响因子：
3.7
作者：
Fotopoulou, Christina;Richter, Rolf;Sehouli, Jalid
通讯作者：
Sehouli, Jalid
影响因子：
2.5
作者：
Sehouli, Jalid;Richter, R.;Fotopoulou, Christina
通讯作者：
Fotopoulou, Christina