卵巢癌肉瘤系列报道

来源 :世界核心医学期刊文摘(妇产科学分册) | 被引量 : 0次 | 上传用户:kvkv
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To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Methods. Thirty-one cases of ovarian carcinosarcoma were identified over a 6- year time period through tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P < 0.05) were used to compare variables with outcome. Results. All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median followup was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly influenced progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease, presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide/cisplatin and 16 patients receiving carboplatin/taxol. Progression-free interval was improved with the use of ifosfamide/cisplatin vs. carboplatin/taxol. The median PFI was 12 months in the carbo/taxol group and has not been reached in the ifos/cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide/cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly influenced by type of adjuvant chemotherapy administered, P = 0.13. Conclusions. Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7- 10 months. Our series, although limited by a small number of patients, exhibits a more encouraging median survival of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide/cisplatin chemotherapy seem to be factors in this improved outcome. To evaluate our experience with ovarian carcinosarcoma and identify prognostic factors. Methods. Thirty-one cases of ovarian carcinosarcoma were identified over a 6-year time period through the tumor registry and pathology records. Fisher exact test and log rank using Kaplan-Meier method (P <0.05) were used to compare variables with outcome. Results. All 31 patients underwent initial surgical treatment with an appropriate staging procedure. Stage distribution: 1 stage I, 6 stage II, 23 stage III, and 1 stage IV. The median followup was 28 months. The median survival for the entire group was 21 months. Early vs. advanced stage significantly affected progression-free interval, P = 0.05. Nineteen patients were found to have stage IIIC disease and required debulking procedures. In patients with stage IIIC disease , presence of residual disease was associated with decreased overall survival, P = 0.03. 29 patients received adjuvant chemotherapy with 11 patients receiving ifosfamide / cisplatin and 16 patients received carboplatin / taxol. Progression-free interval was improved with the use of ifosfamide / cisplatin vs. carboplatin / taxol. The median PFI was 12 months in the carbo / taxol group and has not been reached in the ifos / cisplatin group (P = 0.005). The overall survival was also significantly improved with the use of ifosfamide / cisplatin, P = 0.03. In advanced stage patients, overall survival was not significantly affected by type of adjuvant chemotherapy administered, P = 0.13. Conclusions. Ovarian carcinosarcoma has a poor overall prognosis with median survival rates reported in the literature ranging from 7- 10 months. Our series, although limited by a small number of patients, exhibits a more median duration of 21 months for the overall group. Aggressive debulking to eliminate residual disease and the use of ifosfamide / cisplatin chemotherapy seem to be factors in this improved outcome.
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