医学
阶段(地层学)
内科学
回顾性队列研究
卵巢癌
生存分析
癌
妇科
肿瘤科
胃肠病学
癌症
卵巢癌
古生物学
生物
作者
Majdi Imterat,Nicolò Bizzarri,Robert Fruscio,Anna Myriam Perrone,Alexander Traut,Andreas du Bois,Andrea Rosati,Débora Ferrari,Pierandrea De Iaco,Beyhan Ataseven,Raffaella Ergasti,Silvia Volonté,Marco Tesei,Florian Heitz,Maria Teresa Perri,Nicole Concin,Francesco Fanfani,Giovanni Scambia,Anna Fagotti,Philipp Harter
出处
期刊:International Journal of Gynecological Cancer
[BMJ]
日期:2022-09-14
卷期号:33 (1): 42-49
被引量:3
标识
DOI:10.1136/ijgc-2022-003745
摘要
This international study aimed to investigate the impact of substage, histological type and other prognostic factors on long-term survival for stage I ovarian carcinoma.Our study was a retrospective multicenter cohort study that included patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I (IA-IC3) ovarian carcinoma treated at four European referral centers in Germany and Italy. Using Kaplan-Meier survival curves we compared overall and disease-free survival between the different stage I groups.A total of 1115 patients were included. Of these, 48.4% (n=540) were in stage IA, 6.6% (n=73) stage IB, and 45% (n=502) stage IC, of the latter substage IC1, 54% (n=271), substage IC2, 31.5% (n=158), and substage IC3, 14.5% (n=73). Five-year overall and disease-free survival rates for the entire cohort were 94% and 86%, respectively, with no difference between stage IA and IB. However, there was a significantly better overall and disease-free survival for stage IA as compared with stage IC (p=0.007 and p<0.001, respectively). Multivariate analysis revealed incomplete/fertility-sparing staging (HR 1.95; 95% CI 1.27 to 2.99, and HR 3.54; 95% CI 1.83 to 6.86, respectively), and stage IC (HR 2.47; 95% CI 1.63 to 3.75) as independent risk factors for inferior disease-free survival, while low-grade endometrioid (HR 0.42; 95% CI 0.25 to 0.72) and low-grade mucinous (HR 0.17; 95% CI 0.06 to 0.44) histology had superior disease-free survival. Considering overall survival, stage IC (HR 2.41; 95% CI 1.45 to 4.01) and older age (HR 2.41; 95% CI 1.46 to 3.95) were independent risk factors.Although stage I ovarian carcinoma exhibited excellent outcomes, the prognosis of patients with stage IA differs significantly compared with stage IC. Sub-optimal staging as an indicator for quality of care, and tumor biology defined by histology (low-grade endometrioid/mucinous) independently impact disease-free survival.