Secondary Cytoreduction in Platinum-Resistant Recurrent Ovarian Cancer: A Single-Institution Experience
Secondary Cytoreduction in Platinum-Resistant Recurrent Ovarian Cancer: A Single-Institution Experience
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DOI：
10.1245/s10434-015-4523-2
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发表时间：
2015-12-01
影响因子：
3.7
通讯作者：
Panici, P. Benedetti
中科院分区：
文献类型：
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作者：
Musella, A.;Marchetti, C.;Panici, P. Benedetti
本研究旨在观察二次细胞减灭术在铂类耐药复发卵巢癌(OC)患者中的作用。我们收集了1995-2013年间收治的复发OC患者的数据。纳入标准为：侵袭性上皮性卵巢癌组织学证明、细胞减少术和一线治疗中以铂为基础的化疗，有证据表明治疗完全有效，无疾病间隔和6个月，无伴发肿瘤。将被认为对细胞减少手术敏感的患者(A组)与一系列具有相似特征但不适合手术的患者(B组)进行比较。在122名铂耐药患者中，18人符合纳入标准并纳入研究。他们与历史上18名临床和病理特征相似的未经手术治疗的患者进行了比较。最常见的复发部位包括盆腔和主动脉淋巴结(39%)、腹膜(33%)、肠(28%)和盆腔(22%)。术中和术后并发症发生率低。没有死亡记录。细胞减灭组总生存期明显长于对照组(P=0.035)。中位总生存期为44个月。A组和B组的5年总存活率分别为57%和23.5%，外科手术可以作为化疗的有用辅助手段，在经过精心挑选的中心对铂耐药复发的OC患者进行治疗。需要更大规模的前瞻性试验来进一步证实我们的经验。
The purpose of this study was to observe the role of secondary cytoreductive surgery in platinum-resistant recurrent ovarian cancer (OC) patients.We collected data of patients affected by recurrent OC treated between 1995 and 2013. Inclusion criteria were: invasive epithelial OC histologically documented, cytoreductive surgery and platinum-based chemotherapy at first-line treat ment with evidence of complete response to treatment, disease-free interval < 6 months, and no concomitant neoplasia. Patients considered susceptible of cytoreductive surgery (group A) were compared with a historical series of patients with similar characteristics but not eligible for surgery (group B).Of 122 platinum-resistant patients, 18 met the inclusion criteria for the study and were enrolled. They were compared with a historical series of 18 patients not surgically treated with analogous clinical and pathological features. The most frequent sites of relapse included pelvic and aortic lymph nodes (39 %), peritoneum (33 %), bowel (28 %), and pelvis (22 %). A low rate of intraoperative and postoperative complications was reported. No deaths were recorded. Overall survival was significantly longer in cytoreductive group when compared with the control group (P = 0.035). Median overall survival was 44 months. Estimated 5-year overall survival rates were 57 versus 23.5 % for groups A and B, respectively.Surgery could represent a useful adjunct to chemotherapy in the management of platinum-resistant recurrent OC patients, carefully selected, in highly selected centers. Larger prospective trials are needed to further confirm our experience.