维持激素治疗与晚期低分级浆液性卵巢癌总生存的关系：风险集匹配的回顾性研究

The association of maintenance hormone therapy with overall survival in advanced-stage low-grade serous ovarian carcinoma: A risk-set matched retrospective study

GYNECOLOGIC ONCOLOGY

影响因子:4.1

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: Syem K Barakzai, Amy J Bregar, Marcela G Del Carmen, Eric L Eisenhauer, Annekathryn Goodman, Jose A Rauh-Hain, Allison A Gockley, Alexander Melamed

DOI: 10.1016/j.ygyno.2024.08.004

摘要

我们进行了一项多中心观察性研究，探讨在低分级晚期卵巢癌（LGSOC）首次治疗后，维持激素治疗是否与整体生存优势相关。研究对象为2004年1月1日至2019年12月31日之间在美国癌症委员会认证的癌症中心诊断的组织学确诊为III或IV期LGSOC的患者。将在诊断后六个月内接受激素治疗的患者，与未在此期间启动激素治疗的对照进行风险集倾向评分匹配。主要观察指标为在激素治疗或观察开始后五年内任何原因导致的死亡风险。有296名患者在诊断后六个月内开始激素治疗，另有2805名潜在对照。激素治疗组患者更常在学术医疗中心接受治疗（55%比44%）、诊断时间较晚（62%比23%，在2018-2019年诊断）且初始治疗中无化疗（45%比17%）。风险集倾向评分匹配后，得到225名激素治疗患者和225名对照，两组在测量的协变量方面均衡。在匹配后队列中，激素治疗与死亡风险降低相关（风险比0.60；95% CI 0.38-0.94），对应60个月生存率为75%，而对照组为65%。在LGSOC的主要治疗后，维持激素治疗与优于观察的总体生存期相关。

Abstract

We conducted a multi-institutional observational study to investigate whether maintenance hormone therapy following primary treatment of low-grade advanced-stage ovarian cancer (LGSOC) is associated with an overall survival advantage.We included patients with histologically confirmed stage III or IV LGSOC diagnosed between Jan 1, 2004, and Dec 31, 2019, treated in Commission on Cancer-accredited cancer programs in the US. Patients who received hormone therapy within six months of diagnosis were matched to controls who did not initiate hormone therapy during this timeframe by risk-set propensity score matching. The primary outcome was the risk of death from any cause within five years of initiation of HT or observation.There were 296 patients who initiated maintenance hormone therapy within six months of diagnosis and 2805 potential controls. Patients who received hormone therapy were more often treated in academic medical centers (55% vs. 44%), diagnosed later in the study period (62% vs. 23% diagnosed in 2018-2019), and frequently received no chemotherapy during initial treatment (45% vs. 17%). After risk set propensity score matching, we identified 225 patients treated with HT and 225 untreated controls who were otherwise similar with respect to measured covariates. In the matched cohort, hormone therapy was associated with a reduction in the risk of death (hazard ratio 0.60; 95% CI 0.38-0.94), corresponding to a 60-month survival of 75% compared with 65%.Following primary management of LGSOC, maintenance hormone therapy was associated with improved overall survival compared with observation.