老年卵巢癌患者临床特征及预后分析

Clinical Characteristics and Prognosis of Elderly Patients with Ovarian Cancer

目的:探究老年卵巢癌患者的临床特征、治疗特点及预后的影响因素。方法:回顾性分析2021年6月至2023年6月期间于陕西省肿瘤医院就诊的年龄≥70岁的卵巢癌患者48例,收集临床资料及生存资料,描述并分析其临床特征及预后影响因素。结果:93.7%(45/48)的老年卵巢癌患者诊断时为Ⅲ~Ⅳ期,仅50%的患者接受了手术+化疗±维持治疗的标准治疗模式,且无严重术后并发症及化疗毒副反应,7例患者在治疗过程中行基因检测。标准治疗(P=0.001)、维持治疗(P<0.001)、手术治疗(P=0.001)及手术达R0(P=0.002)的患者无进展生存期(progression-free survival, PFS)显著提高,年龄、分期及是否行新辅助化疗对PFS无显著影响(均P>0.05)。年龄、分期、是否标准治疗、是否维持治疗对总生存期(overall survival, OS)有影响,年龄更大(P=0.005)、分期更晚(P=0.049)与较差的OS显著相关,标准治疗(P<0.001)和维持治疗(P=0.014)者OS显著获益。多因素分析显示标准治疗(HR=0.424,95%CI:0.186~0.967,P=0.041)、维持治疗(HR=0.077, 95%CI:0.010~0.584,P=0.013)是PFS的独立预后因素,而标准治疗(HR=0.053, 95%CI:0.007~0.435,P=0.006)是OS的独立预后因素。结论:绝大多数老年卵巢癌患者诊断时已为晚期,接受标准治疗及基因检测的患者占比偏低,标准治疗及维持治疗对其预后有积极影响。

Objective:To investigate the clinical features,treatment characteristics and the prognostic factors of elderly patients with ovarian cancer.Methods:In this retrospective study,the clinical and survival data of 48 patients with ovarian cancer aged 70 years or older who were treated in Shaanxi Provincial Cancer Hospital from June 2021 to June 2023 were col-lected,and the clinical characteristics and prognosis influencing factors were described and analyzed.Results:93.7%(45/48)of the elderly patients with ovarian cancer were diagnosed as stageⅢ~Ⅳ.Only half received the standard treatment which includes surgery and chemotherapy with or without maintenance therapy,with no serious postoperative complications or chemotherapy side effects.Gene testing during treatment was conducted in 7 patients.The study found that standard treat-ment(P=0.001),maintenance therapy(P<0.001),surgery(P=0.001),and R0 resection(P=0.002)were linked to improved progression-free survival(PFS).Conversely,factors like age,stage,and neoadjuvant chemotherapy did not signifi-cantly impact PFS(all P>0.05).Age,stage,standard treatment and maintenance treatment have a certain impact on overall survival(OS).Older age(P=0.005)and advanced stage(P=0.049)were associated with poorer OS,while standard treatment(P<0.001)and maintenance therapies(P=0.014)were linked to better OS.Multivariate analysis revealed that both standard treatment(HR=0.424,95%CI:0.186~0.967,P=0.041)and maintenance treatment(HR=0.077,95%CI:0.010~0.584,P=0.013)were identified as independent prognostic factors for PFS,whereas standard treatment(HR=0.053,95%CI:0.007~0.435,P=0.006)emerged as an independent prognostic factor for OS.Conclusion:The majority of elderly patients with ovarian cancer were diagnosed at an advanced stage,and a low proportion of patients received standard treatment and gene testing.However,standard treatment and maintenance therapy have a positive impact on the prognosis of patients.