Clinical Study On The Relationship Between Platinum Resistance And Survival Time In Advanced Epithelial Ovarian Cancer

ObjectiveThis study was to explore the relationship between platinum-resistant recurrent advanced epithelial ovarian cancer and survival time,find out the influencing factors of platinum-resistant ovarian epithelial cancer,and provide reference opinions for judging the prognosis of patients with advanced epithelial ovarian cancer and formulating clinical treatment plans.MethodsThis study involved 106 patients with stage III-IV epithelial ovarian cancer who were admitted to the Department of Gynecology and Oncology of Subei People Hospital from 2010 to 2021,the clinical data of all patients were complete.According to the time between the end of chemotherapy and the first recurrence,all patients were divided into two groups.The platinum-resistant group with a recurrence time of less than six months and the platinum-sensitive group with a recurrence time of more than six months.According to different treatment methods,all patients were divided into NACT-IDS group and PDS group.Depending on the route of administration,patients were divided into HIPEC group and intravenous chemotherapy group.The clinical data of two groups were compared,including differences in age,FIGO stages,pathological types,histological grades,platelet count,serum CA125 level,pleural fluid,ascites,ascites exfoliated cells,lymph node metastasis,completeness of cytoreducion score,etc.Discuss the impact of different clinical characteristics on survival.All patients were followed up by telephone or outpatient.The end of follow-up time was the end of the study or the time of death.All data were processed by SPSS 24.0 statistical software,measurement data were expressed as mean±square difference,t test was used for comparison,chi-square test was used for monofactor analysis,logistic regression was used for multiple factor analysis,K-M curve and Cox regression model were used for survival analysis,P<0.05 indicated that the difference was statistically significant.Results1.The results of monofactor analysis affecting the recurrence of platinum-resistant ovarian cancer showed that:(1)The recurrence rate of platinum resistance in the middle/high grade group of histology(36.79%)was significantly higher than that of other types(7.69%)(P=0.037);the rate of platinum resistance recurrence in the patients with PLT>300×10~9/L group(48.39%)was significantly higher than PLT≤300×10~9/L group(22.73%)(P=0.007);the platinum resistance recurrence rate(56.82%)in the CC scores of CC-2/3 group was significantly higher than that of CC-0/1 group(24.19%)(P=0.001);the platinum resistance recurrence rate(47.27%)of patients with ascites volume>1000ml was significantly higher than that of the ascites volume<1000ml group(27.45%)(P=0.035);The recurrence rate of platinum resistance in CA125 positive(>35U/ml)after the second chemotherapy group(69.57%)was significantly higher than that in the negative group(13.33%)(P=0.000).(2)As for age(>50 years or≤50 years),FIGO stages(stage III or IV),pathological types(serous or non-serous),baseline CA125 level(>1000U/ml or≤1000U/ml),pleural fluid(with or without),ascites exfoliated cells(positive or negative),lymph node metastasis(positive or negative),there was no significant difference in the recurrence rate of platinum resistance in each group(all P>0.05).2.The results of multiple factor analysis affecting the recurrence of platinum-resistant advanced ovarian cancer showed that:(1)Platelet count(Exp(B)=0.057,P=0.031)and serum CA125 level after the second chemotherapy(Exp(B)=0.058,P=0.000)were independent risk factors affecting platinum resistance in advanced epithelial ovarian cancer.(2)There was no statistical significance in FIGO stages,histological grades,CC scores,ascites volume,etc.(all P>0.05).3.Survival analysis showed that:(1)The average overall survival of the platinum-resistant group was shorter than the platinum-sensitive group(37.39 vs 54.95 months,P=0.008).(2)For all patients,the CC score(Exp(B)=6.354,P=0.000)and the serum CA125level after the second chemotherapy(Exp(B)=1.993,P=0.034)were independent risk factors affecting the survival of advanced epithelial ovarian cancer.(3)For platinum-resistant patients,the CC score(Exp(B)=5.144,P=0.006)was an independent risk factor that affected the survival of platinum-resistant patients.Conclusions1.Patients with platelet count(>300×10~9/L)and serum CA125-positive(>35U/ml)after the second chemotherapy are more likely to have platinum-resistant recurrence.platelet count and serum CA125 level were independent risk factors on the recurrence of platinum-resistant ovarian epithelial cancer.2.Histological grade(medium/high grade),CC score(CC-2/3),large amount of ascites(>1000ml)and other factors were related to the recurrence of platinum resistance in advanced ovarian epithelial cancer,but they were not independent risk factors.3.Patients with platinum-resistant recurrent advanced epithelial ovarian tumors have shorter survival time and worse prognosis.4.FIGO stage,CC score,platelet count,serum CA125 level after the second chemotherapy and hyperthermic intraperitoneal chemotherapy were important factors that affect the survival of advanced ovarian epithelial cancer.The CC score(CC-2/3),serum CA125 positive(>35U/ml)after the second chemotherapy were independent risk factor that affected the survival of advanced ovarian epithelial cancer.5.CC score,platelet count,and serum CA125 level after the second chemotherapy were important factors that affected the survival of platinum-resistant patients with advanced epithelial ovarian cancer,and CC score(CC-2/3)was the independent risk factor affected the survival of platinum-resistant patients.