Prognostic factors in advanced epithelial ovarian cancer. (Gruppo Interregionale Cooperativo di Oncologia Ginecologica (GICOG)).
Prognostic factors in advanced epithelial ovarian cancer. (Gruppo Interregionale Cooperativo di Oncologia Ginecologica (GICOG)).
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DOI：
10.1038/bjc.1990.315
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发表时间：
1990-09
影响因子：
8.8
通讯作者：
Favalli, G
中科院分区：
文献类型：
--
作者：
Marsoni, S;Torri, V;Valsecchi, M G;Belloni, C;Bianchi, U;Bolis, G;Bonazzi, C;Colombo, N;Epis, A;Favalli, G
本文分析了1978年至1986年由同一协作组连续进行的四项晚期卵巢癌随机试验中914例患者的资料，目的是：（1）确定选定的预后变量对生存的影响;（2）从有利的预后因素和治疗的相互作用中发现，与使用含铂联合化疗相关的生存优势的近似估计值。该系列患者的总3年生存率是历史报告的2倍（22%; 95% CL 18.7-25.4）。采用比例风险回归模型对生存率进行分析。残留肿瘤的大小，年龄，FIGO阶段和细胞类型都是生存的独立决定因素。不同预后组的生存率差异令人印象深刻，5年生存率范围为7 - 62%。然而，这些差异不是定性的（即，最好和最差组的生存动力学相似），表明目前的预后因素对选择“生物学”不同的亚群几乎没有用处。以铂类为基础的治疗方案与总体延长的中位生存期相关，但在预后最佳的亚组（残留肿瘤大小小于2 cm）中未观察到这种获益。这些观察结果的临床研究和卵巢癌患者的护理的影响进行了讨论。
The data on 914 patients enrolled in four randomised trials in advanced ovarian cancer, consecutively conducted by the same cooperative group between 1978 and 1986, were analysed with the aims of: (1) determining the impact of selected prognostic variables on survival; (2) finding, from the interaction of favourable prognostic factors and treatment, an approximate estimate of the magnitude of the survival advantage associated with the use of platinum-based combination chemotherapy. The overall 3-year survival in this series of patients is twice that reported historically (22%; 95% CL 18.7-25.4). The proportional hazard regression model was used to perform the analysis on survival. Residual tumour size, age, FIGO stage and cell type were all independent determinants of survival. Differences in survival from the various prognostic groups were impressive with 5-year survival rates ranging from 7 to 62%. However, these differences were not qualitative (i.e. the kinetics of survival were similar for the best and the worst groups) suggesting that current prognostic factors are of little use for selecting 'biologically' different sub-populations. Platinum-based regimens were associated to an overall prolonged median survival, but this benefit was not observable in the subgroup with most favourable prognosis (less than 2 cm residual tumour size). The implications of these observations for clinical research and ovarian cancer patients care are discussed.