辅助化疗对早期卵巢透明细胞癌生存的影响  

Effect of adjuvant chemotherapy on survival in early-stage ovarian clear cell carcinoma

作　　者：李楠 彭二玄 刘风花 Li Nan;Peng Erxuan;Liu Fenghua(Department of Gynecology,Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450000)

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院妇科,郑州450000

出　　处：《现代妇产科进展》2024年第12期905-909,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨术后辅助化疗对早期卵巢透明细胞癌(OCCC)生存的影响,确定影响早期OCCC生存预后的因素。方法:从SEER数据库中筛选2000年至2019年组织学诊断为早期OCCC的患者,使用倾向评分匹配控制化疗组及未化疗组间的混杂因素,使用Kaplan-Meier法及log-rank检验比较化疗组及未化疗组癌症特异性生存(CSS)的差异,Cox比例风险模型评估临床病理因素与CSS的相关性。结果:根据纳排标准筛选出2446例患者,中位年龄55岁(18~91岁),1772例(72.4%)患者接受术后化疗,674例(27.5%)患者未接受术后化疗。PSM后共有860例患者纳入分析,未化疗组5年CSS率为89.7%,化疗组5年CSS率为88.9%,差异无统计学意义(P=0.480)。分层分析显示,对于Ia/b期患者,化疗组5年CSS率为90.2%,未化疗组5年CSS率为92.1%,差异无统计学意义(P=0.638)。对于Ic期患者,化疗组5年CSS率为85.4%,未化疗组5年CSS率为87.1%,差异均无统计学意义(P=0.689)。单因素及多因素Cox回归分析显示,年龄>48岁、Ic期是影响CSS的危险因素,而术中淋巴结切除数>10枚为保护性因素。结论:I期OCCC患者术后是否辅助化疗,其生存结果相似,Ic期和年龄>48岁患者死亡风险增加,术中淋巴结清扫数量>10枚可降低患者死亡风险。Objective:To investigate the effect of postoperative adjuvant chemotherapy on the survival of early ovarian clear cell carcinoma,and to determine the factors affecting the survival prognosis of early ovarian clear cell carcinoma.Methods:Patients with histologically diagnosed stage I ovarian cell carcinoma from 2000 to 2019 were screened from the SEER database.Propensity score matching was used to control for confounding factors between the chemotherapy group and the non-chemotherapy group.Using Kaplan-Meier method and the log-rank test to compare chemotherapy group and chemotherapy group not cancer-specific survival(cancer-specific survival,CSS)difference,Cox proportional hazards models to evaluate the correlation between clinical pathological factors and CSS.Results:A total of 2446 patients with a median age of 55 years(range,18~91 years)were enrolled.1772 patients(72.4%)received postoperative chemotherapy,and 674 patients(27.5%)did not receive postoperative chemotherapy.A total of 860 patients were encompassed in the analysis subsequent to propensity score matching.The 5-year CSS rate was 89.7%in the non-chemotherapy group and 88.9%in the chemotherapy group(P=0.480).Stratified analysis demonstrated that for stage Ia/b patients,the 5-year CSS rate was 90.2%in the chemotherapy group and 92.1%in the non-chemotherapy group(P=0.638).For stage Ic patients,the 5-year CSS rate was 85.4%in the chemotherapy group and 87.1%in the non-chemotherapy group(P=0.689),and the disparity was not statistically significant.Univariate and multivariate Cox regression analysis indicated that age>48 years and stageⅠc were risk factors for CSS,while the number of intraoperative lymph node dissections>10 was a protective factor.Conclusion:For stage I ovarian clear cell carcinoma,the survival outcomes of patients with or without postoperative adjuvant chemotherapy are comparable.Stage Ic and age>48 years enhance the risk of death,and the number of intraoperative lymph nodes dissected>10 mitigates the risk of death.

关 键 词：上皮性卵巢癌 辅助化疗 生存 预后 

分 类 号：R737.33[医药卫生—肿瘤]