| Objective: To investigate the influence of age, clinical stage,pathological type, residual tumor size and course of chemotherapy on theprognosis of epithelial ovarian cancer.Methods: The clinical data of137epithelial ovarian carcinoma patientswho had been treated in our hospital from July2001to June2011wascollected, including patients,age at diagnosis, clinical stage, pathological type,residual tumor size and course of chemotherapy. All patients were followed-upby telephone and survival outcomes were determined. All patients were stagedaccording to the criteria set by the International Federation of Gynecology andObstetrics (FIGO). The main treatments of these patients were primarysurgery followed by chemotherapy. All surgical pathologic samples wereexamined and diagnosed by the department of pathology. The influences ofage, clinical stage, pathological type, residual tumor size and course ofchemotherapy on the prognosis of epithelial ovarian cancer wereretrospectively studied. All data was statistically analyzed using SPSS19.0software. The Kaplan-Meier method was used for single variable data analysis.Differences of the survival rate were determined using the log-rank test.Average survival time and5-year survival rate were calculated separately forage at diagnosis, clinical stage, pathological type, residual tumor size andcourse of chemotherapy. Cox’s regression model was used to conductmultivariate analysis. The significance test level was P <0.05.Results:1. Analyzed by the Kaplan-Meier method and log-rank test, ourdata showed that patients’ age at diagnosis, clinical stage, residual tumor sizeand course of chemotherapy were associated with the prognosis of epithelialovarian cancer. There was no statistical difference among differentpathological types on the prognosis of ovarian cancer. The average survival time of the younger group (≤50years old) was77.5months and95%confidence interval was [64.110,90.820], the5-year survival rate was65.7%;while the average survival time of the older group (>50years old) was only54.8months and95%confidence interval was [41.624,67.944], the5-yearsurvival rate was27.5%. The difference between the survival rate of these twogroups was significant (P=0.013), which suggested that younger patientshave better prognosis than the older ones. The average survival time of earlystages (I and II) was89.4months and95%confidence interval was[75.631,103.258], the5-year survival rate was77.5%; but the average survivaltime of advanced stages (III-IV) was only51.4months and95%confidenceinterval was [41.002,61.836], the5-year survival rate was30.1%. Thedifference between the survival rate of these two groups was significant (P＜0.01). The average survival time of ideal tumor cytoreductive surgery group(residual tumor size＜2cm) was71.2months and95%confidence interval was[60.668,81.731], the5-year survival rate was52.3%; but the average survivaltime of the unsuccessful cytoreductive surgery group (residual tumor diameter≥2cm) was only25.0months and95%confidence interval was[15.904,34.000], the5-year survival rate was0%. The difference between thesurvival rate of these two groups was significant (P <0.001). The residualtumor size of primary surgery was an important prognostic factor for patientswith epithelial ovarian cancer. The average survival time of patients withserous carcinoma was59.0months and95%confidence interval was [47.090,70.862]. The average survival time of patients with mucinous carcinoma was77.5months and95%confidence interval was [52.068,102.946]. The averagesurvival time of patients with endometrioid carcinoma was76.1months and95%confidence interval was [53.474,98.780]. The average survival time ofpatients with clear-cell carcinomas was56.6months and95%confidenceinterval was [32.165,80.973]. There was no statistical difference amongsurvival rate of different pathological types (P=0.315). The average survivaltime of the≥6courses group was72.7months and95%confidence intervalwas [61.413,84.084], the5-year survival rate was54.4%; but the average survival time of the <6courses group was only40.3months and95%confidence interval was [28.425,52.152], the5-year survival rate was21.2%.The difference between the survival rate of these two groups was significant(P=0.002), which suggested enough courses of chemotherapy can significantlyprolong the survival time of epithelial ovarian cancer patients.2. The clinicalstage, quality of surgery and course of chemotherapy were prognostic factorsinfluencing survival in the final multivariate Cox proportional hazard model.The risk of death for patients with advanced stages was3.559times of theearly-stage ones and95%confidence interval was [1.588,7.973]. The risk ofdeath for patients with residual tumor size>2cm was2.596times of patientswith residual tumor size <2cm and95%confidence interval was[1.292,5.218]. The risk of death for patients who undertook6courses ofchemotherapy or more was0.385times of patients who undertook less than6courses and95%confidence interval was [0.210,0.705].Conclusion: The clinical stage is an important factor affecting theprognosis of epithelial ovarian cancer. The ideal tumor cytoreductive surgeryin conjunction with more than6courses of chemotherapy can significantlyimprove the prognosis of epithelial ovarian cancer. Age and pathological typehave no influence on the prognosis of epithelial ovarian cancer. |
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