复发卵巢癌老年患者预后的相关因素研究

Factors Related to Prognosis of Elderly Patients with Recurrent Ovarian Cancer

目的探讨老年卵巢癌患者的复发临床病理特点以及影响预后的相关因素。方法回顾性调查90例经历了初次手术后静脉注射顺铂/紫杉醇为期6个疗程的卵巢癌患者人口、病理、治疗及预后资料。比例风险模型来评估预后因素与无进展生存期(PFS)和总生存期(OS)的关联性。结果随着年龄的增加,疾病进展(HR=1.06;95%CI=1.02~1.11)和死亡风险增加(HR=1.12;95%CI=1.06~1.18)。相比于浆液性癌,黏液性或透明细胞组织学与较差的PFS和OS相关。与PS 0相比,患者体力状态(PS)1或2会增加复发的风险(HR=1.12;95%CI=1.01~1.24)。相比于镜下残留病灶,患者有0.1~1.0 cm以及>1.0 cm残留病灶(HR=1.96;95%CI=1.70~2.26;HR=2.36;95%CI=2.04~2.73)也会增加复发和死亡的风险(HR=2.11;95%CI=1.78~2.49;P<0.001;HR=2.47;95%CI=2.09~2.92)。结论年龄,PS评分,肿瘤的组织学和残留肿瘤体积是老年卵巢癌复发患者预后的独立预测因子。这些数据可以被用来确定患者的预后和设计未来量身定制的随机临床试验。

Objective To investigate the clinical and pathological features of recurrent ovarian cancer in elderly patients and related prognostic factors. Methods Pathology,treatment and prognosis data of 90 cases of ovarian cancer undergone initial surgery after intravenous injection of cisplatin / paclitaxel for 6 courses were retrospectively analyzed. Proportional hazards model was used to assess the relevance of prognostic factors with progression-free survival( PFS) and overall survival( OS). Results With increasing age,disease progression( HR = 1. 06; 95% CI = 1. 02 ~ 1. 11) and risk of death( HR = 1. 12; 95% CI = 1. 06 ~1. 18) increased. Compared with serous carcinoma,mucinous or clear cell histology were related with poor PFS and OS. Compared with patient performance status( PS) 0,PS 1 or 2 increased the risk of recurrence( HR = 1. 12; 95% CI = 1. 01 ~ 1. 24). Compared with microscopic residual disease,patients had 0. 1 ~ 1. 0 cm,and > 1. 0 cm residual disease( HR = 1. 96; 95% CI = 1. 70 ~2. 26; HR = 2. 36; 95% CI = 2. 04 ~ 2. 73) increased relapse and risk of death( HR = 2. 11; 95% CI = 1. 78 ~ 2. 49; P < 0. 001;HR = 2. 47; 95% CI = 2. 09 ~ 2. 92). Conclusion Age,PS score,tumor histology and residual tumor volume are independent predictors of recurrence and prognosis in elderly patients with ovarian cancer. These data can be used to determine prognosis and future tailored randomized clinical trials.