Tumor type and substage predict survival in stage I and II ovarian carcinoma: Insights and implications
Tumor type and substage predict survival in stage I and II ovarian carcinoma: Insights and implications
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DOI：
10.1016/j.ygyno.2009.09.029
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发表时间：
2010-01-01
影响因子：
4.7
通讯作者：
Swenerton, Kenneth D.
中科院分区：
文献类型：
--
作者：
Koebel, Martin;Kalloger, Steve E.;Swenerton, Kenneth D.
objective.预测生存的能力在确定癌症治疗的需要方面至关重要。卵巢癌肿瘤分型的最新进展导致了一种比分级更可重复和更准确地反映潜在生物学的分类。我们检测了更新的肿瘤类型是否能预测低分期卵巢癌患者的预后。从1984年至2003年诊断为I-II期卵巢癌的1326名妇女的人群队列中，652例病例可用于使用当代标准进行中心病理切片审查。确诊卵巢癌630例。排除了25例罕见类型的卵巢癌，留下605例用于本研究。使用递归分割分析和单变量模型来识别具有优异结果的子集，即，10年疾病特异性生存率（DSS 10年）>= 95%。77例Ia期或Ib期类胶质瘤和粘液性卵巢癌的预后良好[DSS 10y = 95%]。未发现具有极好结局的高级别浆液性类型亚组。Ia期或Ib期透明细胞癌预后较好[DSS 10 y = 87%]，而Ic-II期透明细胞癌预后较好[DSS 10 y = 66%]。根据肿瘤类型（类胶质瘤或粘液瘤）和分期（Ia或Ib），可以确定具有良好结局的卵巢癌患者亚组。分型比分级更易重复，可识别更多I/II期卵巢癌患者，预后良好（12.2% vs. 6.5%），因此在估计卵巢癌死亡风险方面优于分级（上级）。(C)2009 Elsevier Inc，保留所有权利。
Objective. An ability to predict survival is of crucial importance in determining the need for cancer therapy. Recent advances in tumor typing of ovarian carcinomas lead to a classification which is more reproducible and reflects underlying biology more accurately than grade. We tested whether updated tumor type predicts outcome for patients with low-stage ovarian carcinoma.Methods. From a population-based cohort of 1326 women diagnosed with stage I-II ovarian carcinoma between 1984 and 2003, 652 cases were available for central pathological slide review using contemporary criteria. Six hundred thirty cases were confirmed as ovarian carcinoma. Twenty-five ovarian carcinomas of rare types were excluded leaving 605 cases for this Study. Recursive partitioning analysis and univariate models were used to identify subsets with an excellent outcome, i.e., disease-specific survival at 10 years (DSS10y) >= 95%.Results. Seventy-seven ovarian carcinomas of endometrioid and mucinous type, stage Ia or Ib, were associated with an excellent outcome [DSS10y = 95%]. No subset of the high-grade serous type with an excellent outcome could be identified. Clear cell carcinomas of stage la or Ib had a favorable outcome [DSS10y=87%] compared to stage Ic-II [DSS10y=66%].Conclusions. A Subset of ovarian carcinoma patients with an excellent outcome can be identified based on tumor type (endometrioid or mucinous) and stage (Ia or Ib). Type is more reproducibly assigned than grade and identifies a larger cohort of women with stage I/II ovarian carcinoma with favorable outcomes (12.2% vs. 6.5%), and therefore is superior to grade in estimating risk of death from ovarian carcinoma. (C) 2009 Elsevier Inc, All rights reserved.