复发性卵巢性索间质肿瘤的临床特点及预后因素

Clinical characteristics and prognostic factors of recurrent ovarian sex cord stromal tumor

目的:讨论复发性卵巢性索间质肿瘤(OSCST)患者的临床特点及预后相关因素。方法:2012年6月至2021年12月期间武汉大学中南医院共收治OSCST患者127例,对其中随访资料完整的12例复发性OSCST患者进行回顾性研究。结果:12例患者首次复发距初次治疗结束的中位无疾病进展期(PFS)为67.5(6~120)月,除2例仅复发一次外,其余10例患者均经历了2~6次不等的复发过程,总共有33次复发,多次复发的中位PFS为24(1~110)月,最终6例患者死亡,6例患者存活。通过Kaplan-Meier生存分析结果显示复发治疗后的治疗方式(P=0.001)、术后残余瘤(P=0.012)、复发治疗后可测量病灶(P=0.003)与肿瘤复发密切相关。COX多因素分析复发治疗后治疗方式、可测量病灶大小是复发患者的不良预后因素。结论:复发性OSCST患者需根据复发转移部位、残余肿瘤大小等病情严重程度不同选择适当的联合治疗方案,通过尽可能消灭复发转移病灶来延长患者PFS、缓解病情。

Objective:To investigate the clinical characteristics and prognostic factors of patients with recurrent ovarian sex cord stromal tumor(OSCST).Methods:From June 2012 to December 2021,127 patients with ovarian sex cord stromal tumors were treated in Zhongnan Hospital of Wuhan University.In this study,12 patients with recurrent OSCST with complete follow-up data were studied retrospectively.Results:The median progression-free survival(PFS)of the first recurrence from the end of initial treatment was 67.5 months(6-120 months)in the 12 patients.Except that 2 patients had only one recurrence,the other 10 patients experienced a recurrence process ranging from 2 to 6 times,a total of33 recurrences,and the median PFS for multiple recurrences was 24 months(1-110 months).Finally,6 patients died and 6 patients survived.The results of Kaplan-Meier survival analysis showed that treatment strategies(P=0.001),postoperative residual tumor(P=0.012),and measurable lesion after relapse treatment(P=0.003)were strongly associated with tumor recurrence.COX multifactorial analysis of treatment strategies,and measurable lesion size were independent prognostic factors for patients with relapse.Conclusion:In recurrent OSCST patients,choosing the appropriate combination therapy to eliminate the metastatic lesions will help to improve the treatment outcome and prognosis of patients.