复发性卵巢上皮癌患者生存影响因素分析  

Prognostic Factors for patients with recurrent ovarian cancer

作　　者：樊晓妹[1] 牛书怀[1] 李魁秀[1] 单保恩[2] 刘红[1] 

机构地区：[1]河北医科大学第四医院妇瘤科,河北石家庄050000 [2]河北医科大学第四医院科研中心,河北石家庄050000

出　　处：《中华肿瘤防治杂志》2014年第20期1645-1648,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨影响复发性卵巢上皮癌患者生存的因素。方法回顾性分析2004-01-01-2008-12-31河北医科大学第四医院初治,在2011-06-30前复发的173例卵巢上皮癌患者临床及随访资料,应用单因素及多因素Cox回归分析,对可能影响患者预后的相关因素进行分析。结果大部分患者初治时为FIGOⅢ或Ⅳ期（90.2%）、低分化（71.1%）和浆液性性腺癌（71.7%）。复发时中位年龄为53岁,中位无疾病间隔（disease free interval,DFI）为11个月,中位生存时间（survival after recurrence,RS）为37.5个月,中位总生存期（overall survival,OS）为52.3个月。单因素分析结果显示,RS与患者复发年龄（z=-2.086,P=0.037）、复发DFI（χ2=15.494,P=0.001）、首次复发病灶数目（z=-2.573,P=0.010）以及再次手术情况（z=-3.405,P=0.001）有关。OS与患者复发后FIGO分期（z=-3.695,P〈0.001）、DFI（χ2=66.836,P〈0.001）、复发病灶数目（z=-2.392,P=0.017）以及再次手术情况（z=-5.488,P〈0.001）有关。多因素COX回归分析显示,不同DFI的患者间,RS差异有统计学意义,HR及95%CI为0.958（0.934-0.984）;OS差异亦有统计学意义,HR及95%CI为0.914（0.888-0.940）。再次手术情况不同的患者间,RS差异有统计学意义,HR及95%CI为3.270（1.849-5.784）;OS差异亦有统计学意义,HR及95%CI为3.319（1.897-5.807）。结论 DFI、再次手术与否可能是复发卵巢上皮癌患者预后的独立影响因素。OBJECTIVE The prognostic factors for patients with recurrent ovarian cancer was investigated.METHODS We conducted a retrospective review of demographic,clinical outcome data from 173 patients with recurrent epithelial ovarian cancer who were admitted to our hospital from January 1,2004 to December 31,2008 for initial treatment and relapsed before June 30,2011.RESULTS Most patients presented with advanced stage disease,FIGO Ⅲ or Ⅳ（90.2%）,gradesⅢ（71.1%）and serous histology（71.7%）.Median age at recurrence was 53 years,median disease free interval was 11 months,median survival after recurrence was 37.5 months,and median overall survival was 52.3months.Univariate analysis showed that age（z=-2.086,P=0.037）,disease free interval（χ2=15.494,P=0.001）,the number of recurrence sites（z=-2.573,P=0.010）and whether undergoing secondary cytoreduction（z=-3.405,P=0.001）impacted the patients RS with recurrent ovarian cancer.FIGO stage（z=-3.695,P〈0.001）,disease free interval（χ2=66.836,P〈0.001）,the number of recurrence（z=-2.392,P=0.017）and whether undergoing secondary cytoreduction（z=-5.488,P〈0.001）impacted the patients OS with recurrent ovarian cancer.There was significant difference of RS in different groups of DFI,HR and 95%CI were 0.958（0.934-0.984）,there was significant difference of OS in different groups of DFI,HR and 95%CI were 0.914（0.888-0.940）.There was significant difference of RS in different groups of secondary cytoreduction,HR and 95%CI were 3.270（1.849-5.784）,there was significant difference of OS in different groups of secondary cytoreduction,HR and 95%CI were 3.319（1.897-5.807）.CONCLUSIONTreatment free interval and whether undergoing secondary cytoreduction are the independent prognostic factors for patients with recurrent ovarian cancer.

关 键 词：卵巢肿瘤 复发后生存时间 再次肿瘤细胞减灭术 总生存时间 

分 类 号：R737.31[医药卫生—肿瘤]