Clinical behavior of stage II-IV low-grade serous carcinoma of the ovary
Clinical behavior of stage II-IV low-grade serous carcinoma of the ovary
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DOI：
10.1097/01.aog.0000227787.24587.d1
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发表时间：
2006-08-01
影响因子：
7.2
通讯作者：
Bodurka, Diane C.
中科院分区：
文献类型：
--
作者：
Gershenson, David M.;Sun, Charlotte C.;Bodurka, Diane C.
目的：分析在我们的机构进行初次手术后接受铂类药物化疗的II-IV期低级别浆液性卵巢癌患者的临床行为。方法：使用现有数据库确定1978年至2003年的II-IV期低级别浆液性卵巢癌患者。临床病理信息来自医疗记录。无进展生存期和总生存期采用Kaplan-Meier法估计。对数秩检验用于比较存活曲线之间的差异。采用考克斯比例风险回归进行单变量和多变量分析。平均年龄为43岁。90%的人患有III期疾病。86%的患者术前血清CA 125升高。最常见的卵巢外病变部位是网膜、输卵管、盆腔腹膜和子宫。10例可评价患者（15%的大体残留病变患者）对铂类化疗的反应率为80%，42例患者接受了二次手术：显微镜下阴性结果，2例（5%）;显微镜下阳性病变，13例（33%）;肉眼可见阳性病变，24例（62%）;信息不足，3例（7%）。中位无进展生存期和总生存期分别为19.5和81.8个月。原发性化疗后的持续性疾病是与总生存时间较短相关的唯一因素（风险比3.46，95%可信区间2.00-5.97，P
OBJECTIVE: To analyze the clinical behavior of patients with stage II-IV low-grade serous carcinoma of the ovary seen at our institution who underwent primary surgery followed by platinum-based chemotherapy.METHODS: Patients with stage II-IV low-grade serous carcinoma of the ovary from 1978 to 2003 were identified using existing databases. Clinicopathologic information was obtained from medical records. Progression-free survival and overall survival were estimated by the method of Kaplan and Meier. The log-rank test was used to compare differences between survival curves. Univariable and multivariable analyses were performed using Cox proportional hazards regression.RESULTS: We identified 112 eligible patients. Median age was 43 years.; 90% had stage I I I disease. Preoperative serum CA 125 was elevated in 86% of patients. The most common sites of extraovarian disease were omentum, fallopian tubes, pelvic peritoneum, and uterus. Response rate to platinum-based chemotherapy in 10 evaluable patients (15% of patients with gross residual disease) was 80%, and 42 patients underwent second-look surgery: microscopically negative findings, 2 (5%); microscopically positive disease, 13 (33%); macroscopically positive disease, 24 (62%); and insufficient information, 3 (7%). Median progression-free survival and overall survival times were 19.5 and 81.8 months. Persistent disease after primary chemotherapy was the only factor associated with shorter overall survival time (hazard ratio 3.46, 95% confidence interval 2.00-5.97, P