| Objective:By analyzing the clinical data of patients with advanced epithelial ovarian cancer,to explore the factors that affect the 5-year survival time of patients with advanced epithelial ovarian cancer and provide a powerful reference for the future clinical diagnosis and treatment.Method:To collect datas of 234 patients with advanced epithelial ovarian cancer(FIGO stages III and IV)who were treated at the Bethune First Hospital of Jilin University from January 2010 to January 2015.All patients had complete clinical data and no history of other malignant tumor diseases,hematological diseases,and immune system diseases.The clinical data of the patients were retrospectively analyzed,and all patients were followed up by telephone and outpatient visits.The follow-up period was February 2020.Patients were divided into two groups according to survival time,with a survival time of?5 years(75 cases)and a survival time of<5 years(159cases).By retrieving archived cases,the clinical data of two groups of patients were counted and compared,and the factors affecting the 5-year survival of patients with advanced epithelial ovarian cancer were analyzed.Using SPSS17.0 statistical software to collect and analyze datas,establish the receiver operating characteristic curve(ROC curve)to determine the optimal cut-off point for CA125 value,fibrinogen(FBG),monocyte to lymphocyte ratio(MLR),neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR).T-test for measurement data and x~2 test for counting data,Logistic stepwise regression was used for multivariate analysis of prognostic factors.P<0.05 considered that the difference was statistically significant.Results:1.Univariate analysis:(1)Age of illness:The age of illness in patients with a survival group of less than5 years was 25-77 years,with an average age of(55.25±8.88)years.The age of illness in patients with a survival group of 5 years or more was 34-71 years,with an average age of disease(52.32±8.24)years old.Comparing the age of illness between the two groups of patients,the difference was statistically significant(P=0.017).(2)Histological grade:there were 30 cases(19%)of low-grade ovarian cancer in the group with a survival period of less than 5 years and 28 cases(37%)of low-grade ovarian cancer in the group with a survival period of 5 years or more.To analyze the relationship between the histological grade and the prognosis of the two groups,the difference was statistically significant(P=0.002).(3)Postoperative residual lesion diameter:There were 51 cases(32%)of the residual lesion diameter<1cm in the group with a survival period of less than 5years,and 45 cases(60%)of the residual lesion diameter<1cm in the group with a survival period of 5 years or more.The effect of residual lesion diameter on the prognosis of the two groups of ovarian cancer patients was analyzed,and the difference was statistically significant(P=0.000).(4)Postoperative chemotherapy:There were 119 patients(75%)received regular chemotherapy in the group with a survival period of less than 5 years,and 69 patients(92%)with regular chemotherapy in the group with a survival period of 5 years or more.Comparison of the relationship between the regular chemotherapy after surgery and the prognosis of the two groups of patients,the difference is significant(P=0.002).(5)Neoadjuvant chemotherapy:There were 36 patients(23%)received neoadjuvant chemotherapy in the survival group of less than 5 years,and 19 patients(25%)received neoadjuvant chemotherapy in the group with a survival period of 5years or more.Analysis of the relationship between neoadjuvant chemotherapy and survival time between the two groups of patients,the difference was not statistically significant(P>0.05).(6)Platinum-free interval:There were 53 patients(33%)with a platinum-free interval?6 months in the survival group of less than 5 years,and 62 patients(83%)with a platinum-free interval?6 months in the group with a survival period of 5 years or more.Comparing the relationship between the length of platinum-free interval and the prognosis of patients,the difference was statistically significant(P=0.000).(7)CA125 value and CA125 negative time(NT):The ROC curve was drawn to obtain the AUC(ROC curve area)of CA125 in the two groups of patients was0.529,according to the ROC curve,the optimal threshold of CA125 was1106.Comparing the CA125 levels of the two groups of patients,it was found that there was no significant difference(P=0.058).Analyzing the CA125 negative time(NT)of the two groups of patients,there were 51 patients(32%)with NT?8 weeks in the survival group of less than 5 years,and 60 patients(80%)with NT?8 weeks in the group with a survival period of 5 years or more.The relationship between CA125negative time and patient prognosis was analyzed,and the difference was statistically significant(P=0.000).(8)Ascites volume:There were 72 patients(45%)with ascites volume<1000ml in the survival group of less than 5 years,and 46 patients(61%)with ascites volume<1000ml in the group with a survival period of 5 years or more.The effect of ascites on the prognosis of the two groups of ovarian cancer patients was analyzed,and the difference was statistically significant(P=0.022).(9)Hematology index:The ROC curve is plotted to obtain the AUC(ROC curve area)of MLR,NLR,PLR and FBG in the two groups of patients:0.628,0.618,0.592and 0.738,according to the ROC curve,the optimal critical values of MLR,NLR,PLR and FBG are 0.22,3.85,125.77 and 3.58.The MLR,NLR,PLR and FBG were compared between the two groups,and the differences were statistically significant.MLR<0.22,NLR<3.85,PLR<125.77 and FBG<3.58g/L were the factors affecting the prognosis of the patients(all P<0.05).2.Multifactor analysis:The age of illness,platinum-free interval,postoperative residual lesion diameter,regular chemotherapy and FBG are the independent risk factors that affected the5-year survival of patients with advanced epithelial ovarian cancer.Conclusion:1.Compared with patients with a survival time of<<5 years,patients with a survival time of?5 years were relatively younger.2.Univariate analysis showed that satisfactory tumor cytoreductive surgery and regular foot-course chemotherapy can improve the 5-year survival of patients with advanced ovarian cancer;platinum-free interval,CA125 negative time,MLR,NLR,PLR and FBG are associated with the prognosis of patients with advanced epithelial ovarian cancer,and they can be used as an indicator to assess the sensitivity of patients to treatment options and monitor the prognosis of patients;neoadjuvant chemotherapy cannot prolong the survival of patients with advanced ovarian cancer.CA125 levels are not related to the prognosis of patients,both It is not a factor affecting the 5-year survival of patients with advanced epithelial ovarian cancer.3.Multivariate analysis showed that age,platinum-free interval,postoperative residual lesion diameter,regular chemotherapy and FBG are independent risk factors that affect the 5-year survival of patients with advanced epithelial ovarian cancer. |
PDF Full Text Request