辅助化疗对Ⅰ期少见类型卵巢上皮性癌预后的影响:基于人群的倾向性评分匹配分析  

Effects of adjuvant chemotherapy on the prognosis of stageⅠless common epithelial ovarian cancers:Population-based propensity score matching analysis

作　　者：李婧[1] 张钰豪 徐冬冬 林仲秋[1] 卢淮武[1] LI Jing;ZHANG Yu-hao;XU Dong-dong;LIN Zhong-qiu;LU Huai-wu(Department of Gynecological Oncology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong/Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong/Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases,Guangzhou510120,China)

机构地区：[1]中山大学孙逸仙纪念医院妇科肿瘤专科,广东省恶性肿瘤表观遗传学与基因调控重点实验室,广东省妇产疾病临床医学研究中心,广东广州510120

出　　处：《中国实用妇科与产科杂志》2025年第3期353-356,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省基础与应用基础研究基金自然科学基金(2022A1515012432);北京市希思科临床肿瘤学研究基金会(YYoung2022--0145);北京康华中西医发展基金会(KH-2021-LLZX-049);逸仙临床研究培育项目(SYS-C-202001)。

摘　　要：目的探讨辅助化疗对Ⅰ期少见类型卵巢癌上皮性患者的预后影响。方法对2000年1月至2016年12月诊断为Ⅰ期卵巢子宫内膜样癌(EEOC)、透明细胞癌(OCCC)和黏液性卵巢癌(MOC)的患者进行基于美国国家癌症研究所数据库(The Surveillance,Epidemiology,and End Results,SEER)的回顾性病例对照研究。采用倾向性评分匹配法减少选择偏倚,采用Kaplan-Meier法比较辅助化疗对患者5年总生存率的影响,进行多因素Cox分析以控制混杂因素。结果共纳入了4681例国际妇产科联盟(FIGO)Ⅰ期EEOC患者、2450例Ⅰ期OCCC患者和2839例Ⅰ期MOC患者。研究结果显示,辅助化疗不能延长Ⅰ期OCCC患者(86.7%vs.85.9%,P=0.732)和MOC患者(87.6%vs.88.2%,P=0.843)的5年总生存率(OS)。辅助化疗仅与G3ⅠC期EEOC患者的5年OS相关(85.2%vs.67.7%,P=0.008)。结论G3ⅠC期EEOC患者接受辅助化疗有显著的生存获益,然而对于Ⅰ期OCCC和MOC患者来说,辅助化疗可能并非必要.Objective To examine the prognostic benefit of adjuvant chemotherapy in stageⅠLess common ovarian cancers(LCOCs).Methods We conducted a retrospective case‒controlled SEER-based study of stageⅠendometrioid(EEOC),clear cel(l OCCC)and mucinous ovarian cance(r MOC)between 2000 and 2016.Propensity score matching was used to avoid selection bias.Effects of adjuvant chemotherapy on overall surviva(l OS)were compared with Kaplan-Meier tests.Multivariate Cox analyses were performed to control for confounders.Results The study identified 4681 patients with FIGO stageⅠEEOC,2450 with stageⅠOCCC,and 2839 with stageⅠMOC.The results showed that adjuvant chemotherapy could not prolong the 5-year OS of patients with stageⅠOCCC(86.7%vs.85.9%,P=0.732)and MOC(87.6%vs.88.2%,P=0.843).Adjuvant chemotherapy was associated with a 5-year OS benefit only in substageⅠC and grade 3 EEOC patients(85.2%vs.67.7%,P=0.008).Conclusion Patients with G3ⅠC-stage EEOC demonstrate significant survival benefits from adjuvant chemotherapy.However,for patients with stageⅠOCCC and MOC,the necessity of adjuvant chemotherapy remains questionable.

关 键 词：子宫内膜样卵巢癌 透明细胞卵巢癌 黏液性卵巢癌 化疗 美国国家癌症研究所数据库 

分 类 号：R737.3[医药卫生—肿瘤]