期刊
GYNECOLOGIC ONCOLOGY
卷 142, 期 3, 页码 458-464出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2016.06.023
关键词
Primary peritoneal cancer; Ovarian cancer; Neoadjuvant chemotherapy; Interval debulking; Survival; Molecular subtypes
资金
- U.S. Army Medical Research and Materiel Command [DAMD17-01-1-0729]
- Cancer Council Victoria
- Queensland Cancer Fund
- Cancer Council New South Wales
- Cancer Council South Australia
- Cancer Foundation of Western Australia
- Cancer Council Tasmania
- National Health and Medical Research Council of Australia [NHMRC: ID400413, ID40028]
- University of Sydney Cancer Research Fund
- Cancer Institute NSW through the Sydney-West Translational Cancer Research Centre
Objective. Primary peritoneal cancer is rare and considered equivalent to stage III/IV ovarian cancer, but questions remain concerning its underlying biology, prognosis and optimal management. Methods. Clinico-pathological and treatment details of primary peritoneal (n = 120) and ovarian cancer (n = 635) were obtained on women recruited to the Australian Ovarian Cancer Study. Log-rank test was used to compare survival and cox proportional hazards models were fitted to obtain hazard ratios and 95% confidence intervals, both unadjusted and adjusted for age, grade, FIGO stage, residual disease and treatment with neoadjuvant chemotherapy. Molecular subtype was determined by gene expression profiling using published data. Results. Compared with advanced serous ovarian cancer, primary peritoneal cancer patients were older (mean age 65.5 vs. 60.2 years, p<0.001), more often treated with neoadjuvant chemotherapy (38.4% vs. 11.4%, p<0.001). Gene expression profiling classified a substantially higher proportion of primary peritoneal carcinomas as Cl (mesenchymal, reactive stromal infiltration) subtype (70.6% vs. 32.1%, p = 0.029), which was associated with lower complete surgical resection rate. Women with primary peritoneal cancer had significantly shorter progression-free (11.6 vs. 13.6 months, p = 0.007) and overall survival (31.7 vs. 39.8 months, p = 0.012). In multivariate analysis, residual disease and neoadjuvant chemotherapy were both independently associated with increased risk of progression and death. Conclusions. Primary peritoneal cancer patients were more frequently treated with neoadjuvant chemotherapy and had inferior survival. Different tumor biology characterized by activated stromal fibrosis in primary peritoneal cancer may underlie the differences in treatment and clinical outcome. (C) 2016 Elsevier Inc. All rights reserved.
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