| Objective:Study the clinical data of ovarian cancer patients retrospectively to find out the distributional characteristic of ovarian cancer,follow up to identify the true influential factors for the progression free Survival(PFS)and overall survival(OS)of ovarian cancer andto analyze The correlation of TCM syndrome type and FIGO stage,BMI,pretreatment CA125 level,to deriving scientific proof for the clinical work.Methods:For ovarian cancer patients who were primary treated by surgery in Guangdong Provincial Hospital of Traditional Chinese Medicine from 2009 to 2013 were followed up on telephone and data were collected.Univariate analysis was performed using the Fisher exact probability method on SPSS 23.0 software.Logistic regression multivariate analysis was performed in factors which is P<0.05 for univariate analysis.Survival curves were drawn by Kaplan-Meier method to calculate PFS andOS,log-rank test compares differences between groups.Results:A total of 115 patients with ovarian cancer were included,the minimum age was 9 years old,the maximum age was 82 years old,and the average age was 50.93 years old;the overall BMI was 22.21±3.15 kg/m^2,the overweight rate was 19.1%;stage I accounted for 46.1%,stage Ⅱ accounted for 13.0%,stage Ⅲ accounted for 36.5%,stage IV accounted for 4.3%;A total of 100 epithelial ovarian cancer were included,accounting for 87%of all patients,including 38 serous carcinomas,13 mucinous carcinomas,18 endometrioid carcinomas,18 clear cell carcinomas,3 transitional cell carcinomas,and 2 squamous cell carcinoma;6 cases of sexual cord interstitial tumors,accounting for 5.2%,5 cases of germ cell tumors,accounting for 4.3%,4 cases of other types of tumors,accounting for 3.5%;The proportions of highly differentiated,moderately differentiated,poorly differentiated,unclear differentiated were 8.7%、22.6%、42.6%and 26.1%respectively;in serous carcinoma,the positive rate of pretreatment CA125 and CA153 was 92.1%,75.9%reapectively,In mucinous carcinoma,the positive rate of pretreatment CA199 was the highest,reaching 53.8%,followed by CA125,the positive rate was 46.2%,In endometrial cancer,The positive rate of pretreatment CA125 was the highest,reaching 88.9%,and the positive rate of CA153 was 50%.In clear cell carcinoma the positive rate of pretreatment CA125 was the highest,reaching 77.8%,and the positive rate of pretreatment CA199 was 62.5%.The tissue type with higher pretreatment CEA positive rate was mucinous carcinoma(27.3%)and endometrioid carcinoma(18.8%).The mean platelet count before operation in 115 patients with ovarian cancer was 277.48×10^9/L,and 20%of patients had preoperative thrombocytosis.Among the 115 patients,the most common TCM syndromes were 34 cases of kidney deficiency with blood stasis,accounting for 29.6%,25 cases of both deficiency of spleen and kidney with blood stasis,Accounted for 21.7%,16 cases of qi stagnation with blood stasis,accounting for 13.9%,There were 14 cases of spleen deficiency with wet phlegm and blood stasis,accounting for 12.2%.16.5%of patients were pure evil syndrome,and 0.9%of patients were pure deficiency syndrome.82.6%of the patients were mixed with deficiency and evil,66.1%had kidney deficiency,51.3%had spleen deficiency,99.1%had blood stasis,20%had phlegm,14.8%had qi stagnation,and 2.6%had yin deficiency,3.5%hadheat.There was a statistically significant difference in kidney deficiency and spleen deficiency between different FIGO stages.patients with spleen deficiency have higher level of pretreatment CA125.Among the 115 patients,20.9%had Chinese medicine treatment less than 1 month,29.6%had Chinese medicine treatment more than one month but less than 3 month,30.4%had Chinese medicine treatment more than 3 month but less than 6 month,19.1%had Chinese medicine treatment more than 6 month.16 of 115 ovarian cancer patients did not receive chemotherapy,the remaining 99 patients were treated with 5.77±2.01 courses of initial chemotherapy,the courses of initial chemotherapy for patients of stage I to stage IV was 5±1.89 courses、5.79±1.31 courses、6.42±2.07 courses、7.5+1.291 courses respectively.Among them,12 patients underwent neoadjuvant chemotherapy,and the average course of neoadjuvant chemotherapy was 3.17.The TTP of 37 patients with progression was 19.54±15.37 months.The MTTP is 15 months,the TTP from stage I to stage IV was 19.20±18.35 months,19.20±13.88 months,21.46±15.70 months,5.33±2.52 months,respectively.The TTP of patients with low body weight,normalandoverweightwas5±4.24months,20.64±16.4months,19.29±10.81 months repectively;33 patients died and the OS was 39.25±27.43 months,the MOS was 33 months.The 1-year,2-year,3-year,4-year,and 5-year OS of all patients were 97.4%,87.0%,77.4.%,72.2%,and 65.2%,respectively.The 5-year OS of patients with stage I to stage IV were 84.9%,53.3%,47.6%,and 40%,respectively.There were 8 deaths in the group aged≤50 years old.The 3-year and 5-year survival rates were 92.6%and 79.6%respectively.The diseased age>50 years old group died in 24 cases.The 3-year and 5-year survival rates were 63.9%and 52.5 respectively.%.In univariate analysis,age,FIGO stage,histological grade,pretreatment CA125 level,were all associated with 5-yearprogression-free survival and 5-year overall survival,P<0.05,the difference was statistically significant,logistic regression suggested age,FIGO stage was independent influencing factors of 5-year progression-free survival.The difference in the model was statistically significant(χ2=31.706,P<0.001).),the predicted coincidence rate is 76%.Age,FIGO is theindependent influencing factors of 5-year survival,the model difference was statistically significant(x2=23.405,P<0.001),and the prediction coincidence rate was 78.6%.The PFS of who was younger than 50 years old VS50～was 85.27±4.50 months VS 65.73±4.52 months,and the OS was 104.04±4.24 months VS 80.36±5.86 months.The PFS of stage I to stage IV was 104.76±4.39 months,76.37±13,61 months,51.20±6.27 months,25.80±4.52 months,and the OS of stage I to stage IV was 107.83 ± 3.56 months and 90.37±11.28 months,70.45±5.65 months,49.40 ±21.36months respectively.Conclusion:The average age of ovarian cancer is 50.93 years old,epithelial ovarian cancer is the most common histologic type,The TCM syndromes of ovarian cancer is characterized by a composite syndrome type,which is complicated by multiple cases.The blood stasis syndrome accounts a lot in ovarian cancer patients,the disease involves more liver,spleen and kidney,especially spleen and Kidney,the more advanced the stage,the higher the proportion of spleen deficiency syndrome.patients with spleen deficiency have higher level of pretreatment CA125.Low body weight and overweight may associated with shorter TTP but not associated with PFS and OS.Histological type,histological grade,BMI,chemotherapy interval,TCM syndrome type,total duration of Chinese medicine treatment,preoperative thrombocytopenia and pretreatment CA125 were not independent influence factor of PFSand OS in patients with ovarian cancer.age and stage were independent influence factor of PFSand OS in patients with ovarian cancer.Elder than 50 years old,more advanced stage,predict worse PFS and OS of ovarian cancer. |
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