期刊
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
卷 129, 期 -, 页码 70-78出版社
WILEY
DOI: 10.1111/1471-0528.17329
关键词
advanced epithelial ovarian cancer; neoadjuvant chemotherapy; post-relapse survival; primary debulking surgery; recurrence pattern
This study explored the impact of the primary treatment sequence on the post-relapse survival and recurrence characteristics of recurrent epithelial ovarian cancer. The results showed that neoadjuvant chemotherapy and interval debulking surgery were associated with post-relapse survival and may lead to worse recurrence pattern and shorter platinum-free interval.
ObjectiveTo explore the impact of the primary treatment sequence (primary debulking surgery, PDS, versus neoadjuvant chemotherapy and interval debulking surgery, NACT-IDS) on post-relapse survival (PRS) and recurrence characteristics of recurrent epithelial ovarian cancer (REOC). DesignReal-world retrospective study. SettingTertiary hospitals in China. PopulationA total of 853 patients with REOC at International Federation of Gynaecology and Obstetrics stages IIIC-IV from September 2007 to June 2020. Overall, 377 and 476 patients received NACT-IDS and PDS, respectively. MethodsPropensity score-based inverse probability of treatment weighting (IPTW) was performed to balance the between-group differences. Main Outcome MeasuresClinicopathological factors related to PRS. ResultsThe overall median PRS was 29.3 months (95% CI 27.0-31.5 months). Multivariate analysis before and after IPTW adjustment showed that NACT-IDS and residual R1/R2 disease were independent risk factors for PRS (p < 0.05). Patients with diffuse carcinomatosis and platinum-free interval (PFI) <= 12 months had a significantly worse PRS (p < 0.001). Logistic regression analysis revealed that NACT-IDS was an independent risk factor for diffuse carcinomatosis (OR 1.36, 95% CI 1.01-1.82, p = 0.040) and PFI <= 12 months (OR 1.59, 95% CI 1.08-2.35, p = 0.019). In IPTW analysis, NACT-IDS was still significantly associated with diffuse carcinomatosis (OR 1.29, 95% CI 1.05-1.58, p = 0.015) and PFI <= 12 months (OR 1.90, 95% CI 1.52-2.38, p < 0.001). ConclusionsThe primary treatment sequence may affect the PRS of patients with REOC by altering the recurrence pattern and PFI duration.
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