https://scholars.lib.ntu.edu.tw/handle/123456789/613021
標題: | Predicting Long-Term Prognoses and Grading Platinum Sensitivity Using a Novel Progression-Free Interval Criterion in Ovarian Clear Cell Carcinoma: A Multi-Institutional Cohort Study | 作者: | Chou, Cheng-Yang WEN-FANG CHENG Chen, Min-Yu Lin, Hao Ho, Chih-Ming Hung, Yao-Ching Huang, Lee-Wen Wang, Po-Hui Yu, Mu-Hsien Huang, Yu-Fang |
關鍵字: | clear cell carcinoma; ovarian cancer; platinum sensitivity; post-progression therapy; prognostic factors | 公開日期: | 29-三月-2022 | 出版社: | MDPI | 卷: | 14 | 期: | 7 | 來源出版物: | Cancers | 摘要: | This large-scale study aimed to determine the long-term influences of potential prognostic predictors and progression-free interval (PFI) criteria for grading platinum-sensitivity in ovarian clear cell carcinoma (OCCC). We retrospectively reviewed the medical records of OCCC patients presenting at nine tertiary centres (1995-2015), and evaluated patient characteristics, therapeutic factors, clinical outcomes, and hazard ratios for disease progression and death. We enrolled 536 patients (median follow-up, 36.6 months) and developed newly defined distributions of PFIs (seven and 14 months) for grading platinum sensitivity. In the multivariate model, preoperative CA125 levels and chemo-response independently predicted early-stage progression-free survival (PFS) risk. Post-progression cytoreduction correlated with reduced mortality risk. No unfavourable outcomes were observed with respect to coexisting endometriosis, fertility-sparing strategies, or platinum-based regimens. A PFI of <7 months, the strongest predictor of both post-progression mortality and second relapse risks, correlated with chemo-resistance, advanced tumour stage, and shortened post-progression survival. Chemotherapy regimens commonly used in front-line or relapse settings were limited in improving prognoses, especially in the advanced-stage cohort. Clinical trials of novel targeted agents and/or innovative biomarkers for chemoresistance should be comprehensively investigated and offered early to advanced-stage patients or those with OCCC progression occurring within seven months after receiving chemotherapy. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/613021 | ISSN: | 2072-6694 | DOI: | 10.3390/cancers14071746 |
顯示於: | 醫學系 |
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