调查卵巢透明细胞癌的时机和复发部位：JGOG/GCIG试验-JGOG 3017-A3的分析
Investigating the timing and site of recurrence for ovarian clear cell carcinoma: Analysis of the JGOG/GCIG trial-JGOG 3017-A3
影响因子:4.10000
分区:医学2区 Top / 妇产科学1区 肿瘤学2区
发表日期:2024 Nov
作者:
M Yunokawa, N Kurihara, N Ishizuka, H Kanao, H Kajiyama, M Shimada, A Okamoto, D Aoki, T Sugiyama, T Enomoto
摘要
这项研究的目的是在初次治疗卵巢透明细胞癌（OCCC）后使用日本妇科肿瘤学组（JGOG）3017研究的患者的数据进行最佳监测。这项JGOG研究评估了Irinotecan和顺铂组合方案的功效，与紫杉醇和卡泊肽方案的功效相比，接受初级手术的OCCC患者的疗效。在本研究中进行了619例总患者，在本研究中进行了619例总患者，以无效，整体生存，整体生存，估计了进展的范围，估计了估计速度的范围，从而估算了依靠孔孔的范围。进展位点汇总了进展事件的数量，并且考虑到竞争风险，估计了主要进展部位的累积发生率比例。在治疗后12个月时，观察到进展或死亡的峰值危害，并且在24个月之前观察到大多数事件。在治疗后18个月，死亡的危害达到顶峰，大多数事件都在48个月时观察到。治疗后18个月，对肺，肝脏和脾转移的危害保持恒定，此后趋势下降。大多数事件是在18个月之前观察到的。腹膜传播的危害恒定了12个月，此后趋势降低，大多数加重了24个月。骨盆复发的风险在6个月时达到峰值，大多数恶化的发生在24个月中。OCCC的进展事件发生率在12个月时达到峰值，大多数进展事件发生在24个月内。治疗后最初24个月的紧密随访，此后访问较少。但是，密切监测症状并根据不同地点进展率的差异检查患者可能很重要。
Abstract
This study was conducted to determine the optimal monitoring after initial treatment of ovarian clear cell carcinoma (OCCC) using data from patients enrolled in the Japanese Gynecologic Oncology Group (JGOG) 3017 study. The JGOG study evaluated the efficacy of an irinotecan and cisplatin combination regimen compared with that of a paclitaxel and carboplatin regimen for OCCC patients who underwent primary surgery.Yielding 619 total patients in this study, to analyze progression-free and overall survival, the hazards over time were estimated using kernel smoothing curves to identify the peak of event occurrence. The number of progression events was summed by progression site, and the cumulative incidence proportion was estimated for the major progression sites, considering competing risks.The peak hazard for progression or death was observed at 12 months post-treatment, and most events were observed by 24 months. The hazard for death peaked at 18 months post-treatment, with most events being observed by 48 months. The hazard for lung, liver, and spleen metastases remained constant for 18 months post-treatment, with a decreasing trend thereafter; most events were observed by 18 months. The hazard for peritoneal dissemination was constant for 12 months, with a decreasing trend thereafter, with most exacerbations observed by 24 months. The risk of pelvic recurrence peaked at 6 months, with most exacerbations observed by 24 months.The incidence of progression events for OCCC peaked at 12 months and most progression events occurred within 24 months. Close follow-up for the initial 24 months post-treatment and fewer visits thereafter may be acceptable. However, closely monitoring symptoms and examining patients based on differences in progression rates at different sites may be important.