[Combined treatment and prognostic analysis of advanced epithelial ovarian carcinoma].
OBJECTIVE
To evaluate the effects of combined treatment for advanced epithelial ovarian carcinoma and to analyze its prognostic factors.


METHODS
Fifty-three patients treated with a three-step combined therapeutic regimen were defined as research arm. The procedures of the three-step combined treatment were as follows: induction of tumor remission, sequential chemotherapy and adjuvant immunotherapy. Three hundred and eighteen patients with advanced epithelial ovarian carcinoma treated with cytoreductive surgery and systemic chemotherapy were retrospectively classified into control arm.


RESULTS
The rates of complete response and partial response in the research arm were significantly differed from those in the control arm (90.6%, 5.7% Vs 70.1%, 5.3%, P < 0.01). The 1-, 2- and 3-year survival rates of the research arm and control arm were 97.7%, 89.1%, 83.6% Vs 71.8%, 44.1%, 29.8%, respectively (P < 0.01). The 1-, 2- and 3-year tumor-free survival rates of the research arm and control arm were 92.6%, 75.0%, 75.0% Vs 60.3%, 37.8%, 28.6%, respectively (P < 0.01). The 1- and 2-year recurrent rates of the patients in research arm were much lower than that in control arm (7.5%, 25.0% Vs 39.7%, 62.2%, P < 0.01). Age, stage, ascites, differential degree, preoperative chemotherapy (intraperitoneal and/or intravenous chemotherapy), postoperative intraperitoneal chemotherapy and systemic chemotherapy were poor prognostic factors. Initially treated in other hospital, bilateral tumors, large residuals (diameter more than 1cm) and postoperative intraperitoneal chemotherapy were poor tumor-free survival prognostic factors.


CONCLUSIONS
Combined therapy including remission induction, consolidation chemotherapy and immunotherapy was able to enhance therapeutic efficacy, decrease the 1- and 2-year recurrent rate and improve the survival of patients with advanced epithelial ovarian carcinoma.
Department of Gynecology, Cancer Hospital, Fudan University, Shanghai 200032, China.
Xiao
X
Huang
Shumo
S
Cai
Jianxuan
J
Fan
Ziting
Z
Li
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D016896:Treatment Outcome