| Object:To discuss the influence of epithelial ovarian cancer(EOC) patients’ age、surgical procedure、clinical stages、pathological pattern、organization class、lymphatic metastasis、whether the postoperative CA125 value drop to normal、the size of the residual lesion surgery 、 postoperative chemotherapy treatment course and have or not preoperative adjuvant chemotherapy to EOC patients’ long term efficacy.Method:To collect the EOC patients’ clinical data who doctor in the Oncology hospital of Shanxi Province between 2000 January1 and 2009 December 31.Which includes age 、surgical procedure、clinical stages、pathological pattern、organization class、lymphatic metastasis、whether the postoperative CA125 value drop to normal、the size of the residual lesion surgery、postoperative chemotherapy treatment course and have or not preoperative adjuvant chemotherapy and so on. FIGO staging method for patients with clinical stage. To give a combined therapy priority to with surgical treatment method, adjuvanting chemotherapy; all the pathological pattern and organization class of the postoperative pathological specimen. Ascertained by the pathology department of our hospital, aquire the treatment and survival by telephone follow up. All the data analysised by SPSS 17.0statistical software, Univariate analysis accoding to Kaplan-Meier method, use Log-rank to test the difference of survival rate(The significance of statistic difference defined as P<0.05).Respectively calculate the median survival time and five-year survival rate 、ten-year survival rate of patient according to patients’ age、surgical procedure、clinical stages 、 pathological pattern 、 organization class 、 lymphatic metastasis 、 whether the postoperative CA125 value drop to normal 、 the size of the residual lesion surgery 、postoperative chemotherapy treatment course and have or not preoperative adjuvant chemotherapy. Multiple-factor analysis adopt COX proportional hazards regressionmodel( Elected to the variable is P≤0.05,get rid of P>0.10).Result:1.Compare the data by Kaplan-Meier method and discover that the age、clinical stage、pathological pattern、the size of the residual lesion surgery、postoperative chemotherapy treatment course、whether get right of the post operative CA125 value is intimately related with patients’ prognosis.Different surgical procedures and whether preoperative adjuvant chemotherapy are regardless of significance in their statistics.(1)The total median survival time is fifty months,95%CI is( 47.833,62.167),fifty-year survival rate is thirty-seven percent,ten-year survival rate is six percent;( 2) Age: of 149 case patient,the median survival time is fifty-nine months of the ≤40 years old,95%CI is(39.821,79.179),five-years survival time is twenty-nine percent,ten-year survival time is zero percent;the median survival time of the patient between forty-one and forty-nine is eighty-five months,95%CI is(49.667,120.333),five-year survival rate is fifty-nine percent, ten-year survival time is zero percent; The median survival time of the patient between fifty and fifty-nine is fifty-seven months,95%CI is(38.672,75.328),five-year survival time is forty-three percent,ten-year survival time is six percent; the median survival time of the patient ≥60 years old is thirty-five months,95%CI is(19.981,50.019),five-year survival rate is twenty-three percent, ten-year survival time is five percent. The difference of the survival rate is significant(P=0.002),indicates that the prognosis of between 40 and 60 years old is better than the older and the younger.(3)Clinical stage: the median survival time of stage I is one hundred and twenty-three months,95% CI is(68.468,177.532),five-year survival rate is74.3 percent, ten-year survival rate is 30.3 percent; the median survival time of stage II is sixty months,95%CI is(55.974,64.026),five-year survival rate is 37.5 percent, ten-year rate is zero percent;the median survival time of stage III is forty-two months,95%CI is(38.014,45.986),five-year survival rate is 29.4 percent,ten-year survival rate is zero percent;the survival time of the stage IV patient is thirty-one months,95%CI is(25.456,36.544),five-year survival rate is 12.5 percent,ten-year survival rate is zero percent. The difference of survival rate is significant(P<0.001),indicates that the prognosis of early stage is better than advanced stage.(4)Residual lesions:The median survival time of the residual lesions diameter<2cm after tumor remove surgery is 123 months,95%CI is(70.562,175.438), five-year survival rate is 64.3 percent,ten-year survival rate is 27.5percent. The median survival time of residual lesions diameter ≥ 2cm is 41 months,95%CI is(37.075,44.925),five-year survival rate is 30.2 percent, ten-year survival rate0.0percent.The survival rate difference of two-pack patient is significant(P<O.001).(5)Postoperative CA125 value: the median survival time of the CA125 value has got right is62 months,95%CI is(40.494,83.506), five-year survival rate is 51.47 percent,ten-year survival rate is 22.2 percent. the median survival time of the CA125 value hasn’t got right is 26 months,95%CI is(16.833,36.167), five-year survival rate is 28.67 percent,ten-year survival rate is 0 percent. The significance of them is obvious(P<0.001).(6)Postoperative chemotherapy course: the median survival time of the chemotherapy course less than six courses is 48 months, 95%CI is(44.061,51.939).five-year survival rate is 33.5percent,ten-year survival rate is 11.4 percent; the median survival time of the chemotherapy course more than six courses is 60 months,95%CIIS(37.540,82.460),five-year survival rate is 47.8 percent, ten-year survival rate is 28.2 percent.statistical difference is obvious(P=0.033).(7)Pathological pattern: The median survival time of serous fluid papillary adenocarcinoma is 55 months,95% CI is(45.716,64.284),five-year survival rate is 43.0 percent,ten-year survival rate is 17.8 percent;the median survival time of mucinomas papillary adenocarcinoma is 66 months,95%CI is(24.158,107.842),five-year survival rate is 51.9 percent,ten-year survival rate is 0%.The median survival time of transitional cell carcinoma is 57 months,95%CI is(0,162.207), five-year survival rate is 41.6 percent,ten-year survival rate is 0%. the median survival time of clear cell carcinoma is 41 months,five-year survival rate is 0%,ten-year survival rate is 0%;the median survival time of endometriod carcinoma is 57 months,95%CI is(0,118.005),five-year survival rate is 27.8%,ten-year survival rate is 0%;the median survival time of mixed type cell carcinoma is 4 months,both of five year and ten year survival rate is0%,the difference is significant(P<0.001).(8) Preoperation chemotherapy:the median survival time that haven’t carried out chemotherapy is 55 months,95%CI is(46.728,63.272),five-year survival rate is 43%,ten-year survival rate is 23.5%; the median survival time that have carried out chemotherapy is 42 months,95%CI is(14.841,69.159),five-year survival rate is 25%,ten-year survival rate is 0.0%.the difference is not significant(P=0.117).(9) The difference is not significant of different surgical procedure( P=0.114).(10) Most patient hadn’t carried out histological class and lymphadectomy,this topic won’t research it.2. Multiple-factor analysis adopt COX proportional hazards regression model discovers that the age and residual lesions diameter is the independent risk factor of EOC.(1)We make the mortality risk of the patient less than 40 years old as 1, the mortality risk of the patient between 40 and 49 is0.403,95%CI is [0.216,0.752];the mortality risk of the patient between 50 and 59 is0.759,the mortality risk of the patient more that 60 years old is 1.736.(2)We make the mortality risk of the patient residual lesions diameter less than 1cm as 1,the mortality risk of the residual lesions diameter between 1cm and 2cm is 2.619,95%CI is[1.190,5.722],the mortality risk of the residual lesions diameter more that 2cm is 3.114, 95 % CI is[1.950,4.973].Conclusion:Age is an important factor to impacting EOC patients’ survival outcome。Cutting off the lesion thoroughly can improve the long-term follow-up result of EOC patient.Surgical procedure、 preoperative chemotherapy、chemotherapy course of postoperation、pathological pattern、clinical stage、whether the CA125 value of postoperation return to normal aren’t intimately related with the treatment effect of EOC patient. |
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