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卵巢、输卵管及腹膜癌:基于人群的预后因素与结局比较

Cancer of the ovary, fallopian tube, and peritoneum: a population-based comparison of the prognostic factors and outcomes.

作者信息

Rottmann Miriam, Burges A, Mahner S, Anthuber C, Beck T, Grab D, Schnelzer A, Kiechle M, Mayr D, Pölcher M, Schubert-Fritschle G, Engel J

机构信息

Munich Cancer Registry (MCR) of the Munich Tumour Centre (TZM), Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany.

Department of Gynaecology and Obstetrics, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany.

出版信息

J Cancer Res Clin Oncol. 2017 Sep;143(9):1833-1844. doi: 10.1007/s00432-017-2422-6. Epub 2017 Apr 26.

Abstract

PURPOSE

The objective was to compare the prognostic factors and outcomes among primary ovarian cancer (OC), fallopian tube cancer (FC), and peritoneal cancer (PC) patients in a population-based setting.

METHODS

We analysed 5399 OC, 327 FC, and 416 PC patients diagnosed between 1998 and 2014 in the catchment area of the Munich Cancer Registry (meanwhile 4.8 million inhabitants). Tumour site differences were examined by comparing prognostic factors, treatments, the time to progression, and survival. The effect of the tumour site was additionally analysed by a Cox regression model.

RESULTS

The median age at diagnosis, histology, and FIGO stage significantly differed among the tumour sites (p < 0.001); PC patients were older, more often diagnosed with a serous subtype, and in FIGO stage III or IV. The time to progression and survival significantly differed among the tumour sites. When stratified by FIGO stage, the differences in time to progression disappeared, and the differences in survival considerably weakened. The differences in the multivariate survival analysis showed an almost identical outcome in PC patients (HR 1.07 [0.91-1.25]) and an improved survival of FC patients (HR 0.63 [0.49-0.81]) compared to that of OC patients.

CONCLUSION

The comparison of OC, FC, and PC patients in this large-scale population-based study showed differences in the prognostic factors. These differences primarily account for the inferior outcome of PC patients, and for the improved survival of FC compared to OC patients.

摘要

目的

本研究旨在比较基于人群的原发性卵巢癌(OC)、输卵管癌(FC)和腹膜癌(PC)患者的预后因素及结局。

方法

我们分析了1998年至2014年间在慕尼黑癌症登记处辖区(约480万居民)诊断出的5399例OC患者、327例FC患者和416例PC患者。通过比较预后因素、治疗方法、疾病进展时间和生存率来研究肿瘤部位差异。此外,通过Cox回归模型分析肿瘤部位的影响。

结果

肿瘤部位之间的诊断时中位年龄、组织学类型和国际妇产科联盟(FIGO)分期存在显著差异(p < 0.001);PC患者年龄较大,更常被诊断为浆液性亚型,且处于FIGO III期或IV期。肿瘤部位之间的疾病进展时间和生存率存在显著差异。按FIGO分期分层时,疾病进展时间的差异消失,生存率差异显著减弱。多因素生存分析的差异显示,与OC患者相比,PC患者的结局几乎相同(风险比[HR]为1.07[0.91 - 1.25]),而FC患者的生存率有所提高(HR为0.63[0.49 - 0.81])。

结论

在这项基于大规模人群的研究中,OC、FC和PC患者的比较显示出预后因素存在差异。这些差异主要解释了PC患者较差的结局以及FC患者相较于OC患者生存率提高的原因。

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