| ObjectiveA retrospective study was performed to collect clinical and pathological data from patients with advanced primary epithelial ovarian cancer(AEOC).To observe the efficacy of neoadjuvant chemotherapy followed by interval debulking surgery(NACT-IDS)and primary debulking surgery(PDS)in advanced epithelial ovarian cancer.Simultaneous analysis of prognostic factors in patients with advanced epithelial ovarian cancer,provide a reference for the clinical diagnosis and treatment of advanced epithelial ovarian cancer.MethodsThe clinical data of 420 patients with AEOC who were admitted to the Shandong Cancer Hospital affiliated to Shandong University from January 1,2013 to January 31,2016 were retrospectively analyzed.To explore the different international obstetrics and gynecology alliance(FIGO)staging,age,tissue type,tissue grading,ideal degree of cytoreductive,chemotherapy route(intraperitoneal chemotherapy IP and intravenous chemotherapy IV),initial treatment chemotherapy cycle,CA125 level after treatment The effect of treatment after relapse(second and multiple cytoreduction combined with chemotherapy and only chemotherapy)on survival.At the same time,the basic clinical and pathological data,the ideal degree of tumor reduction,the overall survival(OS)and the progression-free survival(PFS)of neoadjuvant chemotherapy(NACT)group and primary debulking surgery(PDS)group were observed.ResultsThe average age of patient was 54.2 years old;the main symptoms were abdominal distension,a total of 215 cases,accounting for 59.0%;the pathological type was mainly serous,a total of 361 cases,accounting for 96.4%;pathological grade was mainly G3(low differentiation),a total of 233 cases,accounting for 64.0%;FIGO stage was mainly in stage III,a total of 296 cases,accounting for 81%.The basic clinical and pathological data of NACT group and PDS group were analyzed.It was found that there were statistical differences in age,stage,pathological type and grade between the two groups.The overall survival rates of the PDS group and the NACT group were 38.6%and 44.9%,respectively,and the difference was not statistically significant(P=0.772),The progression-free survival rates were 9.1%and 16.8%,respectively,and the difference was not statistically significant(P=0.367).The ideal rate of tumor reduction in the NACT group was significantly higher than that in the PDS group,and the difference was statistically significant(P<0.001).Univariate analysis showed that FIGO stage,age,ideal degree of tumor reduction,chemotherapy route,amount of CA125 after treatment,and treatment after recurrence were correlated with prognosis(P<0.05).Multivariate analysis showed that FIGO stage,age,and ideal degree of tumor reduction,the amount of CA125 after treatment,and the treatment mode after recurrence were independent prognostic factors affecting the overall survival of patients with epithelial ovarian cancer(P<0.05).Conclusions1.By observing the basic clinical pathological data,it was found that there were some differences in the choice of patients in the NACT group and the PDS group.The age of NACT group was significantly higher than that of PDS group;the number of patients in stage IV of NACT group was significantly higher than that of PDS group;non-serous multiple choice PDS;pathological type of patients with moderately and highly differentiated PDS,all the above factors were statistically significant.difference.Patients are advised to carefully assess the ideal degree of neutropenia and the risk of perioperative period before treatment.If it is difficult to achieve ideal cytoreductive and perioperative risk,recommend NACT.2.There was no statistical difference between OS and PFS in PDS group and NACT group,but it can be seen that NACT group has a tendency to improve OS and PFS.In particular,the PFS was improved;the trend of improving the survival rate of patients in stage IV was more obvious(34.8%:18.2%).It can be seen that both PDS and NACT are alternative treatments for patients with advanced epithelial ovarian cancer.It is worth noting that because of the differences in different patients and tumors,we have to choose the best treatment according to different situations,so the pre-treatment evaluation is especially important.3.The ideal rate of tumor reduction in the NACT group was significantly higher than that in the PDS group.The difference was statistically significant,and the number of patients with no tumor after surgery was significantly higher than that of the PDS group.It can be seen that NACT can reduce the difficulty of surgery and improve the ideal degree of tumor reduction.4.FIGO stage,age,ideal degree of tumor reduction,chemotherapy route,CA125 level after treatment,and treatment after recurrence were associated with prognosis(all P<0.05).Among them,FIGO stage,age,ideal degree of tumor reduction,level of CA125 after treatment,and treatment after recurrence were independent prognostic factors affecting the overall survival of patients with epithelial ovarian cancer(P<0.05). |
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