Impact of incomplete surgery and adjuvant chemotherapy for the intraoperative rupture of capsulated stage I epithelial ovarian cancer: a multi-institutional study with an in- depth subgroup analysis

Masato Yoshihara; Satoshi Tamauchi; Shohei Iyoshi; Kazuhisa Kitami; Kaname Uno; Kazumasa Mogi; Hiroaki Kajiyama

doi:https://doi.org/10.3802/jgo.2021.32.e66

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자료유형: 학술저널

저자정보: Masato Yoshihara (Nagoya University Graduate School of Medicine) Satoshi Tamauchi (Nagoya University Graduate School of Medicine) Shohei Iyoshi (Nagoya University Graduate School of Medicine) Kazuhisa Kitami (Nagoya University Graduate School of Medicine) Kaname Uno (Nagoya University Graduate School of Medicine) Kazumasa Mogi (Nagoya University Graduate School of Medicine) Hiroaki Kajiyama (Nagoya University)

저널정보: 대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.32 No.5

발행연도: 2021.9

수록면: 1 - 9 (9page)

DOI: https://doi.org/10.3802/jgo.2021.32.e66

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Objective: The aim of the present study was to examine the effects of incomplete surgery and adjuvant chemotherapy on the prognosis of patients with intraoperative rupture of capsulated stage I epithelial ovarian cancer (OvCa). Methods: A regional retrospective study was conducted between 1986 and 2019. Among 4,730 patients with malignant ovarian tumors, 534 women with International Federation of Gynecology and Obstetrics stage IA and IC1 epithelial OvCa were eligible. Differences in survival outcomes were examined between patients with stage IA and IC1 tumors and the effects of uterine preservation, complete-staging lymphadenectomy, and adjuvant chemotherapy were investigated by an in-depth subgroup analysis. To analyze therapeutic effects, baseline imbalances were adjusted using propensity score (PS). Results: The prognosis of patients with stage IC1 tumors was worse than those with stage IA. Surgical spill did not affect the site of recurrence. In the PS-adjusted subgroup analysis, uterine preservation (hazard ratio [HR]=1.669; 95% confidence interval [CI]=1.052?2.744), incomplete-staging lymphadenectomy (HR=1.689; 95% CI=1.211?2.355), and the omission of adjuvant chemotherapy (HR=3.729; 95% CI=2.090?6.653) significantly increased the HR of recurrence for patients with stage IC1 tumors compared to those with stage IA tumors. Adjuvant chemotherapy decreased the impact of rupture with uterine preservation (HR=0.159; 95% CI=0.230?1.168) or incomplete-staging lymphadenectomy (HR=0.987; 95% CI=0.638?1.527). Conclusion: The present results suggest intraoperative rupture of capsulated stage I epithelial OvCa is associated with a poor prognosis. When chemotherapy is given for patients receiving incomplete surgery, there is no longer an increased risk of recurrence observed with the rupture.

#Adjuvant Chemotherapy #Fertility Effect #Lymph Node Excision #Ovarian Cancer #Rupture #Spontaneous

참고문헌 (21)

참고문헌 신청

Siegel RL / 2018 / Cancer statistics, 2018 / CA Cancer J Clin 68:7~30

2018 / 2016 Annual report of the Committee on Gynecologic Oncology / Acta Obstet Gynaecol Jpn 70:1372~1444

2017 / 2015 Annual report of the Committee on Gynecologic Oncology / Acta Obstet Gynaecol Jpn 69:1171~1216

Heintz AP / 2006 / Carcinoma of the ovary. FIGO 26th annual report on the results of treatment in gynecological cancer / Int J Gynaecol Obstet 95(Suppl 1):S161~S192

Sou Hirose / 2018 / Retrospective analysis of sites of recurrence in stage I epithelial ovarian cancer / Journal of Gynecologic Oncology 29(3):1~11

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