Conservative management of early-stage epithelial ovarian cancer: results of a large retrospective series
Conservative management of early-stage epithelial ovarian cancer: results of a large retrospective series
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DOI：
10.1093/annonc/mds241
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发表时间：
2013-01-01
影响因子：
50.5
通讯作者：
Colombo, N.
中科院分区：
文献类型：
--
作者：
Fruscio, R.;Corso, S.;Colombo, N.
为了评估早期卵巢上皮癌（ES/EOC）年轻女性患者行生育保留手术（FSS）治疗的长期肿瘤学结局和生育能力，本分析考虑了两个意大利中心所有接受FSS治疗的ES/EOC患者。使用单变量和多变量分析来测试人口统计学特征和临床特征与总生存期（OS）、无复发生存期（RFS）和生育能力的相关性。从1982年到2010年，240名恶性ES/EOC患者在意大利的两个三级中心接受了FSS治疗。中位随访时间为9年，27例患者复发（11%），11例（5%）死于疾病进展。多因素分析发现，仅3级对患者的预后有负面影响[复发风险比（HR）：4.2，95%置信区间（CI）：1.5-11.7，P = 0.0067;死亡风险比（HR）：7.6，95% CI：2.0-29.3，P = 0.0032]。3级也与卵巢外复发显著相关（P = 0.006）。在105例（45%）试图怀孕的患者中，84例（80%）成功。当肿瘤局限于卵巢时，可以建议所有年轻患者进行保守治疗，因为卵巢复发总是可以成功管理的。G3肿瘤患者更有可能发生远处复发，应密切监测。
To assess the long-term oncological outcome and the fertility of young women with early-stage epithelial ovarian cancer (ES/EOC) treated with fertility-sparing surgery (FSS).All patients treated with FSS for ES/EOC in two Italian centers were considered for this analysis. Univariate and multivariate analyses were used to test demographic characteristics and clinical features for the association with overall survival (OS), recurrence-free survival (RFS) and fertility.From 1982 to 2010, 240 patients with malignant ES/EOC were treated with FSS in two tertiary centers in Italy. At a median follow-up of 9 years, 27 patients had relapsed (11%) and 11 (5%) had died of progressive disease. Multivariate analysis found only grade 3 negatively affected the prognosis of patients [hazard ratio (HR) for recurrence: 4.2, 95% confidence interval (CI): 1.5-11.7, P = 0.0067; HR for death: 7.6, 95% CI: 2.0-29.3, P = 0.0032]. Grade 3 was also significantly associated with extra-ovarian relapse (P = 0.006). Of the 105 patients (45%) who tried to become pregnant, 84 (80%) were successful.Conservative treatment can be proposed to all young patients when tumor is limited to the ovaries, as ovarian recurrences can always be managed successfully. Patients with G3 tumors are more likely to have distant recurrences and should be closely monitored.