Clinical features of long-term survivors of recurrent epithelial ovarian cancer
Clinical features of long-term survivors of recurrent epithelial ovarian cancer
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DOI：
10.1007/s10147-014-0687-1
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发表时间：
2015-02-01
影响因子：
3.3
通讯作者：
Takeshima, Nobuhiro
中科院分区：
文献类型：
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作者：
Iwase, Haruko;Takada, Toshio;Takeshima, Nobuhiro
虽然复发性上皮性卵巢癌（EOC）通常被认为是一种无法治愈的疾病，但一些患者在首次复发后存活超过5年。本研究的目的是评估获得长期生存的复发性EOC患者的临床特征。方法回顾性分析164例复发性EOC患者的临床分期、组织学亚型、初次治疗、无病间期（DFI）、复发部位、二次治疗及首次复发后总生存期（R-OS），采用Kaplan-Meier法和log-rank检验。结果164例患者中位R-OS为25个月，5年R-OS率为25.4%。不同分期的R-OS差异无统计学意义。6-12个月DFI组（23个月）的中位R-OS显著短于>= 12个月DFI组（61个月）（p = 0.0002），而6-12和3-6个月DFI组（20个月）之间无显著差异（p = 0.161）。在164例患者中，只有14例在首次复发后存活了50年。大多数患者在化疗的同时接受手术和/或放疗，在整个治疗过程中接受了约18个周期的铂类化疗（中位22个周期，范围4-44）。结论：如果维持对铂的高敏感性，复发性EOC患者在重复铂基化疗周期后可能延长生存期。此外，当化疗联合二次细胞减少手术和/或放疗时，他们的预后得到改善。
Background Although recurrent epithelial ovarian cancer (EOC) is generally regarded as an incurable disease, some patients survive more than 5 years after the first recurrence. The aim of this study was to evaluate the clinical features of patients with recurrent EOC who achieve long-term survival.Methods We retrospectively reviewed the medical records of 164 patients with recurrent EOC and analyzed the clinical stage, histologic subtype, primary treatment, disease-free interval (DFI), recurrence site, secondary treatment, and overall survival from the time of the first recurrence (R-OS), using the Kaplan-Meier method and the log-rank test.Results The median R-OS for all 164 patients was 25 months and the 5-year R-OS rate was 25.4 %. There were no significant differences in R-OS according to the disease stage. The median R-OS was significantly shorter in the 6-12-month DFI group (23 months) than in the >= 12-month DFI group (61 months) (p = 0.0002), while there was no significant difference between the 6-12 and 3-6-month DFI groups (20 months) (p = 0.161). Of the 164 patients, only 14 survived >5 years after the first recurrence. Most of them underwent surgery and/or radiotherapy in combination with chemotherapy and underwent >18 cycles of platinum-based chemotherapy throughout their treatments (median 22 cycles; range 4-44).Conclusions If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.