Primary Radical Surgery in Elderly Patients With Epithelial Ovarian Cancer Analysis of Surgical Outcome and Long-Term Survival
Primary Radical Surgery in Elderly Patients With Epithelial Ovarian Cancer Analysis of Surgical Outcome and Long-Term Survival
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DOI：
10.1111/igc.0b013e3181c10c04
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发表时间：
2010-01-01
影响因子：
4.8
通讯作者：
Sehouli, Jalid
中科院分区：
文献类型：
--
作者：
Fotopoulou, Christina;Savvatis, Konstantinos;Sehouli, Jalid
目的：老年人口的预期寿命越来越长，老年妇女上皮性卵巢癌（EOC）的发病率也越来越高。我们研究的目的是确定根治性细胞减少手术的影响，根治性细胞减少手术是原发性EOC临床治疗的基石，在这一人群中特别考虑到相关的发病率。方法：通过汇总数据分析，根据经过验证的文献资料收集工具，评估癌症相关患者的特征、术中肿瘤类型、手术和临床结果。Kaplan-Meier曲线计算总生存期（OS）。进行Cox回归分析以确定死亡率的独立预测因子。结果：101例年龄大于69岁的EOC患者（平均[SD]年龄75.54[4.49]岁）被评估。平均（SD）随访22.63（22.92）个月。国际先进妇产科联合会III期（60.4%）是最常见的肿瘤分期。45例患者（44.6%）肿瘤完全切除，并发症发生率为40.6%。术后死亡率为6%。平均OS为47.29个月（95%可信区间36.24-58.34）。多因素分析发现，年龄大于75岁、肿瘤切除不完全和缺乏辅助化疗会对OS产生负面影响。结论：原发性EOC根治性手术获得肿瘤完全切除与老年患者的OS显著延长相关（>= 70年）。必须考虑到术后发病率的增加，强调了这一特殊集体对特殊跨学科术后管理的高要求。
Objective: Geriatric population life expectancy is increasing and so is the incidence of epithelial ovarian cancer (EOC) in elderly women. The aim of our study was to determine the impact of radical cytoreductive surgery, the cornerstone of clinical management in primary EOC, in this population with special regard to the associated morbidity.Methods: Through a pooled data analysis, cancer-related patient characteristics, intraoperative tumor pattern, and surgical and clinical outcomes were evaluated according to a validated documentation data collection tool. Kaplan-Meier curves were calculated for overall survival (OS). The Cox regression analysis was performed to identify independent predictors of mortality.Results: One hundred one EOC patients older than 69 years (mean [SD] age, 75.54 [4.49] years) were evaluated. The mean (SD) follow-up period was 22.63 (22.92) months. Advanced International Federation of Gynecology and Obstetrics stage III (60.4%) was the most common tumor stage. A complete tumor resection was achieved in 45 patients (44.6%) with an associated complication rate of 40.6%. The postoperative mortality was 6%. The mean OS was 47.29 months (95% confidence interval, 36.24-58.34). The multivariate analysis identified age older than 75 years, incomplete tumor resection, and absence of adjuvant chemotherapy to negatively affect OS.Conclusions: Radical surgery for primary EOC obtaining complete tumor resection is associated with a significantly prolonged OS in elderly patients (>= 70 years). The increased postoperative morbidity must be considered, underlining the high requirement for special interdisciplinary postoperative management in this special collective.