维持激素疗法与高级低级浆液卵巢癌的总生存率的关联：一项风险匹配的回顾性研究
The association of maintenance hormone therapy with overall survival in advanced-stage low-grade serous ovarian carcinoma: A risk-set matched retrospective study
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:
Syem K Barakzai, Amy J Bregar, Marcela G Del Carmen, Eric L Eisenhauer, Annekathryn Goodman, Jose A Rauh-Hain, Allison A Gockley, Alexander Melamed
摘要
我们进行了一项多机构的观察性研究，以调查低级别晚期卵巢癌（LGSOC）的维持激素治疗是否与整体生存优势有关。我们包括接受组织学确认的III期或IV期LGSOC的患者，在2004年1月1日和2019年12月31日之间诊断为2019年12月31日，在2019年12月31日，在癌症上进行了癌症的治疗。在诊断后六个月内接受激素治疗的患者与对照组相匹配，这些对照在此期间通过风险集倾向评分匹配在此期间未启动激素治疗。主要结果是在启动HT或观察后五年内死亡的风险。有296名患者在诊断后的六个月内开始维持激素治疗和2805个潜在控制。接受激素治疗的患者在学术医疗中心（55％vs.44％）经常接受治疗，在研究期后期被诊断为诊断（62％vs。在2018 - 2019年被诊断为23％），在初始治疗期间经常没有接受化学疗法（45％vs. 17％）。在风险设定倾向得分匹配之后，我们确定了225名接受HT治疗的患者和225例未经治疗的对照，这些患者在测量的协变量方面与众不同。在匹配的队列中，激素疗法与死亡风险降低有关（危险比0.60; 95％CI 0.38-0.94），对应于60个月的生存率为75％，而65％的生存率为65％。与LGSOC相比，LGSOC的一级管理，维持激素治疗与不良的总体生存相关。
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.