| Objective: To summarize the clinical data of patients with platinum-sensitive recurrent epithelial ovarian cancer and explore the related factors of disease-free interval(DFI)after initial treatment.The correlation between DFI and overall survival.Analyzing the factors which affect the overall survival and prognosis of these patients.In order to further understand the patter n of recurrence of ovarian epithelial cancer and provide a basis for prolonging DFI and improving patient prognosis.Methods: To retrospectively analysis the clinical data of these 80 patients with platinum-sensitive recurrent ovarian epithelial cancer who visited the Ningxia Medical University General Hospital and Cardio-Cerebrovascular Hospital from January 2007 to December 2017 and completed the first systemic treatment.Analyzing the Influential factors of disease-free interval such as: age,pathological type,histological grade,FIGO staging,postoperative residual lesion size,platelet count before treatment and the number of chemotherapy courses after the first operation.The relationship between disease-free interval and the overall survival.Receiver operating characteristic curve(ROC)method was used to determine the cut-off value of Serum CA125 level before treatment and platelet count affecting the prognosis of 80 patients,the patients were divided into two groups and including other factors such as: age,histological grade,FIGO staging and postoperative residual lesion size.The Kaplan-Meier method was used todescribe the survival curves of different groups' patients and the differences in survival between the groups was tested by log-rank.Results:(1)Univariate analysis suggested that tumor's histological grade,FIGO staging,postoperative residual lesion size,and platelet count before treatment were related to the patient's disease-free interval(P< 0.05).The age of the patients,tumor's pathological type and the number of chemotherapy courses have no relation to the disease-free interval(P> 0.05).(2)The histological grade,FIGO staging,postoperative residual lesion size,and platelet count were included in the Cox proportional hazards model.Suggesting that the residual lesion size(RR = 0.276,95% CI: 0.132 ~ 0.578,P = 0.001)and pre-treatment platelet count(RR = 0.454,95% CI: 0.242 ~ 0.850,P = 0.014)are independent factors affecting the patient's disease-free interval.(3)Positive correlation was found between disease-free interval and overall survival(rs = 0.628,P = 0.000).(4)Six of the 80 patients with platinum-sensitive recurrent epithelial ovarian cancer who recurred within 1 year,accounting for 7.5%,53 recurred within 2 years,accounted for 66.3% and 73 recurred within 3 years,accounting for 91.3%,79 cases recurred during the 5 years,accounting for 98.8%.(5)The 2-year,3-year,4-year,and 5-year survival rate of these patients are 90.0%,66.3%,50.0%,and 38.7%.(6)After using the Receiver operating characteristic curve to determine the serum CA125 level before treatment and platelet count cutoff value.It was concluded that the survival rate was lower in the group with serum CA125 level> 984U/ml,the difference are statistically significant(?2 = 13.232,P = 0.000);In a similar way people whose platelets > 387× before treatment has the lower survival rate and the difference are statistically significant(?2 = 8.127,P = 0.004);the difference in survival rate between the histological grades of the poorly differentiated group was statistically significant(?2 = 9.689,P = 0.002)and thesurvival rate of patients with the size of the residual lesions between 1~ 2cm was lower,the difference was statistically significant(?2 = 19.954,P = 0.000).There were no statistically significant differences in survival rates among patients of different ages,histological grades,clinical FIGO stages,and numbers of chemotherapy courses(P> 0.05).Conclusion :(1)The disease-free interval of these patients with platinum-sensitive recurrent epithelial ovarian cancer was related to the histological grade,FIGO staging,the residual lesion size and the platelet count before treatment.(2)Residual lesion size and platelet count before treatment were independent factors which affecting the disease-free interval in patients with platinum-sensitive recurrent epithelial ovarian cancer.(3)The shorter the disease-free interval in patients,the shorter the overall survival.(4)The p rognosis of patients with serum CA125 level before treatment are > 984U/ml,platelet count >387 ×,poorly differentiated,or residual lesions ?1cm is often poor. |
PDF Full Text Request