A recurrence-predicting prognostic factor for patients with ovarian clear-cell adenocarcinoma at reproductive age
A recurrence-predicting prognostic factor for patients with ovarian clear-cell adenocarcinoma at reproductive age
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DOI：
10.1007/s10147-013-0645-3
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发表时间：
2014-10-01
影响因子：
3.3
通讯作者：
Kikkawa, Fumitaka
中科院分区：
文献类型：
--
作者：
Kajiyama, Hiroaki;Mizuno, Mika;Kikkawa, Fumitaka
我们回顾性分析了132例育龄期卵巢透明细胞腺癌（CCC）患者的临床病理特征，并评估了复发的预后指标。在1986年至2011年期间，作为一项基于区域人群的研究，根据中央病理审查系统收集了132例年轻CCC患者的临床病理数据，采用单因素和多因素分析评价无复发生存率（RFS），中位年龄为40（27-45）岁。存活患者的中位随访期为46.4个月。在观察期间，87例I期肿瘤患者中有16例复发（18.4%），17例II期肿瘤患者中有8例复发（47.1%），28例III-IV期肿瘤患者中有16例复发（57.1%）。随后，35名患者死于该病。I期或II期患者未达到RFS中位数。III-IV期的中位RFS为21.6个月。当分析仅限于I期患者时，CCC患者IA和IC（r）（术中囊破裂）的RFS无显著差异（P = 0.7957）。与IC（r）组相比，IC（non-r）组的RFS较IC（r）组差（P < 0.0001）。在局限于I期患者的多变量分析中，亚期组仅是RFS的独立预后因素[IA vs. IC（非r）] [风险比（HR）= 9.394; 95%CI，1.445-61.070; P = 0.0190]。我们应该记住IC期或更高的患者复发的风险更大，除了那些术中破裂的IC期患者。
We retrospectively analyzed the clinicopathological features and evaluated the prognostic indicators of recurrence in 132 patients with clear cell adenocarcinoma (CCC) of the ovary at reproductive age.Between 1986 and 2011, as a regional population-based study, clinicopathological data on 132 young patients with CCC, collected under the central pathological review system, were subjected to uni- and multivariable analyses to evaluate recurrence-free survival (RFS).The median age was 40 (27-45) years. The median follow-up period for surviving patients was 46.4 months. During the observation period, there were 16 recurrences in 87 patients with stage I tumors (18.4 %), 8 in 17 with stage II (47.1 %), and 16 in 28 with III-IV (57.1 %). Subsequently, 35 patients died of the disease. Those with stage I or II did not reach the median RFS. The median RFS of stage III-IV was 21.6 months. When analysis was confined to stage I patients, there was no significant difference in the RFS of CCC patients between IA and IC(r) (intraoperative capsule rupture) (P = 0.7957). In contrast, CCC patients with IC excluding IC(r) [IC(non-r)] showed a poorer RFS than those with IC(r) (P < 0.0001). In multivariable analysis confined to stage I patients, the substage group was only an independent prognostic factor for RFS [IA vs. IC(non-r)] [hazard ratio (HR) = 9.394; 95 % CI, 1.445-61.070; P = 0.0190].We should keep in mind the greater risk of recurrence in patients with stage IC disease or higher, other than those stage IC patients with intraoperative rupture.