Lack of improved survival plus increase in thromboembolic complications in patients with clear cell carcinoma of the ovary treated with platinum versus nonplatinum-based chemotherapy
Lack of improved survival plus increase in thromboembolic complications in patients with clear cell carcinoma of the ovary treated with platinum versus nonplatinum-based chemotherapy
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DOI：
10.1002/(sici)1097-0142(19961115)78:10
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发表时间：
1996-11-15
期刊：
影响因子：
6.2
通讯作者：
Driscoll, DL
中科院分区：
文献类型：
--
作者：
Recio, F;Piver, MS;Driscoll, DL
背景。本研究旨在评估接受铂类化疗与非铂类化疗的透明细胞卵巢癌患者的生存率以及血栓栓塞并发症的风险。方法。对 111 名接受初次手术和术后治疗的透明细胞卵巢癌患者进行回顾性评估。中位随访时间为 21.3 个月（范围：3-280 个月）。根据分期、年龄、分级、手术范围和血栓栓塞并发症的发生情况对接受铂类化疗和非铂类化疗的患者进行评估。使用卡方检验对患者群体进行比较。使用 Kaplan 和 Meier 的方法计算每组的估计 5 年和 10 年生存率。使用对数秩检验计算存活率的差异。将透明细胞卵巢癌组中血栓栓塞并发症的发生率与由 109 名上皮性非透明细胞卵巢癌患者组成的匹配对照组的发生率进行比较。 结果。 71 名患者接受非铂类化疗，40 名患者接受铂类化疗。接受铂类化疗或非铂类化疗的患者群体的特征没有统计学上的显着差异。接受铂类化疗的卵巢透明细胞癌患者的估计 5 年生存率与接受非铂类化疗的透明细胞卵巢癌患者的估计 5 年生存率没有显着差异（36% vs. 32%；P = 0.23）。 12 名透明细胞卵巢癌患者在初次手术后出现了血栓栓塞并发症，而在接受铂类化疗的非透明细胞卵巢癌患者的匹配对照组中，没有患者出现血栓栓塞并发症（P = 0.0004）。接受铂类化疗的 40 名透明细胞卵巢癌患者中有 8 名 (20%) 出现血栓栓塞并发症，而接受非铂类化疗的 71 名患者中有 4 名 (6%) 出现血栓栓塞并发症 (P = 0.03)。多变量逻辑回归分析表明，血栓栓塞并发症的发生与透明细胞卵巢癌和铂类化疗显着相关，并对生存产生显着的负面影响（P = 0.009）。结论。与非铂类化疗相比，铂类化疗似乎并未改善透明细胞卵巢癌患者的生存率。铂类化疗和透明细胞卵巢癌的联合显着增加血栓栓塞并发症的风险，并对生存产生显着的负面影响。 (C) 1996 年美国癌症协会。
BACKGROUND. This study was conducted to evaluate survival rates for patients with clear cell ovarian carcinoma who had platinum-based chemotherapy versus nonplatinum-based chemotherapy and the risk of thromboembolic complications.METHODS. One hundred and eleven evaluable patients with clear cell ovarian carcinoma who underwent primary surgery and postoperative therapy were retrospectively evaluated. Median follow-up was 21.3 months (range, 3-280 months). Patients treated with platinum-based chemotherapy and nonplatinum-based chemotherapy were evaluated according to stage, age, grade, extent of surgery, and development of thromboembolic complications. Patient populations were compared using the chi-square test. Estimated 5- and 10-year survivals for each group were calculated using the method of Kaplan and Meier. Differences in survival rates were calculated using the log rank test. The frequency of thromboembolic complications in the clear cell ovarian carcinoma group was compared with its frequency in a matched-control group of 109 patients with epithelial nonclear cell ovarian carcinoma.RESULTS. Seventy-one patients were treated with nonplatinum-based chemotherapy and 40 patients were treated with platinum-based chemotherapy. There was no statistically significant difference in the characteristics of patient populations treated with platinum-based chemotherapy or nonplatinum-based chemotherapy. The estimated 5-year survival for clear cell ovarian carcinoma patients treated with platinum-based chemotherapy did not differ significantly from the estimated 5-year survival for patients with clear cell ovarian carcinoma treated with nonplatinum-based chemotherapy (36% vs. 32%; P = 0.23). Twelve patients with clear cell ovarian carcinoma developed thromboembolic complications remote from primary surgery, whereas in a matched-control group of patients with nonclear cell ovarian carcinoma treated with platinum-based chemotherapy, no patients developed a thromboembolic complication (P = 0.0004). Eight of 40 patients (20%) with clear cell ovarian carcinoma treated with platinum-based chemotherapy developed thromboembolic complications, whereas 4 of 71 patients (6%) treated with nonplatinum-based chemotherapy developed thromboembolic complications (P = 0.03). Multivariate logistic regression analysis demonstrated that the development of a thromboembolic complication was significantly related to clear cell ovarian carcinoma and platinum-based chemotherapy and had a significant (P = 0.009) negative impact on survival.CONCLUSIONS. Platinum-based chemotherapy did not appear to improve survival compared with nonplatinum-based chemotherapy of patients with clear cell ovarian carcinoma. The combination of platinum-based chemotherapy and clear cell ovarian carcinoma significantly increases the risk for thromboembolic complications and has a significant negative impact on survival. (C) 1996 American Cancer Society.