印度尼西亚的低粒径浆液性癌症：中等收入国家最大的多中心队列的见解

摘要(中文译文)

低级别浆液性卵巢癌（LGSOC）是上皮性卵巢癌的一种罕见亚型，以生长缓慢和化疗敏感性有限为特征。然而，来自低收入和中等收入国家的数据有限。本研究旨在描述印度尼西亚LGSOC患者的临床和病理特征。这项回顾性多中心研究在七个省份的九家三级癌症中心开展，纳入2019年1月至2024年12月期间根据2020年世界卫生组织女性生殖系统肿瘤分类确诊、经组织学证实的LGSOC患者。从病历中提取人口学、临床、手术、病理和治疗数据。复发分为初次治疗完成后的早期复发（<6个月）或晚期复发（≥6个月）。采用Fisher精确检验分析临床病理变量与结局之间的关联。进行Kaplan-Meier（KM）生存分析及log-rank检验和Cox比例风险回归，并采用限制性多变量模型以减少因事件数有限导致的过拟合。共纳入160例患者（中位年龄46岁；范围17-75岁），中位随访24个月。在该队列中，约50%表现为晚期疾病（国际妇产科联盟III-IV期，50%）。分别有43.1%和70.6%的患者观察到腹水和癌抗原-125水平升高。90%的病例接受了初次肿瘤细胞减灭术，72.5%实现了最佳肿瘤细胞减灭。总体复发率为10%，92.5%的患者在末次随访时存活。KM分析显示，晚期疾病和残留病灶患者的生存较差。在单变量Cox回归中，残留病灶（HR，7.93）和复发（HR，10.06）与死亡率的关联最强。在多变量分析中，仅残留病灶仍为独立预测因素（校正HR，5.59；P=0.013）。在该多中心队列中，残留病灶是生存的关键决定因素，凸显了完全肿瘤细胞减灭术和早期诊断的重要性。

Abstract

Low-grade serous ovarian cancer (LGSOC), a rare subtype of epithelial ovarian cancer, is characterized by indolent growth and limited chemosensitivity. However, data from low- and middle-income countries are limited. The present study aimed to describe the clinical and pathological characteristics of patients with LGSOC in Indonesia. This retrospective multicenter study was conducted at nine tertiary cancer centers across seven provinces, and included patients with histologically confirmed LGSOC diagnosed according to the 2020 World Health Organization Classification of Female Genital Tumors between January 2019 and December 2024. Demographic, clinical, surgical, pathological and treatment data were extracted from medical records. Recurrence was classified as early (<6 months) or late (≥6 months) after completion of primary treatment. Associations between clinicopathological variables and outcomes were analyzed using Fisher's exact test. Kaplan-Meier (KM) survival analysis with log-rank testing and Cox proportional hazards regression were performed, with a restricted multivariate model to minimize overfitting due to limited events. A total of 160 patients (median age, 46 years; range, 17-75 years) were included, with a median follow-up of 24 months. Of the cohort, ~50% presented with advanced-stage disease (International Federation of Gynecology and Obstetrics III-IV, 50%). Ascites and elevated cancer antigen-125 levels were observed in 43.1 and 70.6% of patients, respectively. Primary debulking surgery was performed in 90% of cases, achieving optimal cytoreduction in 72.5%. The overall recurrence rate was 10, and 92.5% of patients were alive at the last follow-up. KM analysis showed worse survival in patients with advanced-stage disease and residual disease. In univariate Cox regression, residual disease (HR, 7.93) and recurrence (HR, 10.06) showed the strongest associations with mortality. In multivariate analysis, only residual disease remained an independent predictor (adjusted HR, 5.59; P=0.013). In this multicenter cohort, residual disease was the key determinant of survival, underscoring the importance of complete cytoreductive surgery and early diagnosis.

如何引用

Molecular and clinical oncology 的其他文献

• 淫羊藿苷：用于乳腺癌多阶段预防和治療的多靶点天然产物（综述）
• 前列腺癌症体积调制电弧治疗期间与早期不良事件相关的尿代谢组学特征：公共数据集的二次分析
• 大肠癌组织中微小RNA的表达及意义分析
• 癌症中的单核细胞分布宽度：来自回顾性探索性试验研究的结果