Abstract：
To determine oncological outcomes and associated prognostic factors in women younger than 45 years diagnosed with non-epithelial ovarian cancer.
A retrospective, multicenter Spanish study was performed including women with non-epithelial ovarian cancer younger than 45 years between January 2010 and December 2019. All types of treatments and stages at diagnosis with at least 12 months of follow-up were collected. Women with missing data, epithelial cancers, borderline or Krukenberg tumors, and benign histology, as well as patients with previous or concomitant cancer, were excluded.
A total of 150 patients were included in this study. The mean±SD age was 31.45±7.45 years. Histology subtypes were divided into germ cell (n=104, 69.3%), sex-cord (n=41, 27.3%), and other stromal tumors (n=5, 3.3%). Median follow-up time was 58.6 (range: 31.10-81.91) months. Nineteen (12.6%) patients presented with recurrent disease with a median time to recurrence of 19 (range: 6-76) months. Progression-free survival and overall survival did not significantly differ among histology subtypes (p=0.09 and 0.26, respectively) and International Federation of Gynecology and Obstetrics (FIGO) stage (I-II vs III-IV) with p=0.08 and p=0.67, respectively. Univariate analysis identified sex-cord histology with the lowest progression-free survival. Multivariate analysis showed that body mass index (BMI) (HR=1.01; 95% CI 1.00 to 1.01) and sex-cord histology (HR=3.6; 95% CI 1.17 to 10.9) remained important independent prognostic factors for progression-free survival. Independent prognostic factors for overall survival were BMI (HR=1.01; 95% CI 1.00 to 1.01) and residual disease (HR=7.16; 95% CI 1.39 to 36.97).
Our study showed that BMI, residual disease, and sex-cord histology were prognostic factors associated with worse oncological outcomes in women younger than 45 years diagnosed with non-epithelial ovarian cancers. Even though the identification of prognostic factors is relevant to identify high-risk patients and guide adjuvant treatment, larger studies with international collaboration are essential to clarify oncological risk factors in this rare disease.
A retrospective, multicenter Spanish study was performed including women with non-epithelial ovarian cancer younger than 45 years between January 2010 and December 2019. All types of treatments and stages at diagnosis with at least 12 months of follow-up were collected. Women with missing data, epithelial cancers, borderline or Krukenberg tumors, and benign histology, as well as patients with previous or concomitant cancer, were excluded.
A total of 150 patients were included in this study. The mean±SD age was 31.45±7.45 years. Histology subtypes were divided into germ cell (n=104, 69.3%), sex-cord (n=41, 27.3%), and other stromal tumors (n=5, 3.3%). Median follow-up time was 58.6 (range: 31.10-81.91) months. Nineteen (12.6%) patients presented with recurrent disease with a median time to recurrence of 19 (range: 6-76) months. Progression-free survival and overall survival did not significantly differ among histology subtypes (p=0.09 and 0.26, respectively) and International Federation of Gynecology and Obstetrics (FIGO) stage (I-II vs III-IV) with p=0.08 and p=0.67, respectively. Univariate analysis identified sex-cord histology with the lowest progression-free survival. Multivariate analysis showed that body mass index (BMI) (HR=1.01; 95% CI 1.00 to 1.01) and sex-cord histology (HR=3.6; 95% CI 1.17 to 10.9) remained important independent prognostic factors for progression-free survival. Independent prognostic factors for overall survival were BMI (HR=1.01; 95% CI 1.00 to 1.01) and residual disease (HR=7.16; 95% CI 1.39 to 36.97).
Our study showed that BMI, residual disease, and sex-cord histology were prognostic factors associated with worse oncological outcomes in women younger than 45 years diagnosed with non-epithelial ovarian cancers. Even though the identification of prognostic factors is relevant to identify high-risk patients and guide adjuvant treatment, larger studies with international collaboration are essential to clarify oncological risk factors in this rare disease.
摘要：
目的：确定诊断为非上皮性卵巢癌的45岁以下女性的肿瘤结局和相关预后因素。
方法：回顾性研究，进行了多中心西班牙研究，包括2010年1月至2019年12月期间45岁以下的非上皮性卵巢癌女性。收集所有类型的治疗和诊断阶段以及至少12个月的随访。数据缺失的女性，上皮癌,临界或Krukenberg肿瘤，和良性组织学，以及先前或伴随癌症的患者，被排除在外。
结果：本研究共纳入150例患者。平均±SD年龄为31.45±7.45岁。组织学亚型分为生殖细胞（n=104，69.3％），性索（n=41，27.3%），和其他间质瘤（n=5，3.3％）。中位随访时间为58.6（范围：31.10-81.91）个月。19例（12.6%）患者出现疾病复发，中位复发时间为19个月（范围：6-76个月）。无进展生存期和总生存期在组织学亚型（分别为p=0.09和0.26）和国际妇产科联合会（FIGO）分期（I-IIvsIII-IV）之间没有显着差异，p=0.08和p=0.67，分别。单变量分析确定了无进展生存期最低的性索组织学。多因素分析表明，体重指数（BMI）（HR=1.01；95％CI1.00至1.01）和性索组织学（HR=3.6；95％CI1.17至10.9）仍然是无进展生存的重要独立预后因素。总生存期的独立预后因素是BMI(HR=1.01;95%CI1.00~1.01)和残留病变(HR=7.16;95%CI1.39~36.97)。
结论：我们的研究表明BMI，残留病,和性索组织学是与45岁以下诊断为非上皮性卵巢癌的女性肿瘤预后较差相关的预后因素.尽管识别预后因素与识别高危患者和指导辅助治疗有关，与国际合作的大型研究对于阐明这种罕见疾病的肿瘤危险因素至关重要.
方法：回顾性研究，进行了多中心西班牙研究，包括2010年1月至2019年12月期间45岁以下的非上皮性卵巢癌女性。收集所有类型的治疗和诊断阶段以及至少12个月的随访。数据缺失的女性，上皮癌,临界或Krukenberg肿瘤，和良性组织学，以及先前或伴随癌症的患者，被排除在外。
结果：本研究共纳入150例患者。平均±SD年龄为31.45±7.45岁。组织学亚型分为生殖细胞（n=104，69.3％），性索（n=41，27.3%），和其他间质瘤（n=5，3.3％）。中位随访时间为58.6（范围：31.10-81.91）个月。19例（12.6%）患者出现疾病复发，中位复发时间为19个月（范围：6-76个月）。无进展生存期和总生存期在组织学亚型（分别为p=0.09和0.26）和国际妇产科联合会（FIGO）分期（I-IIvsIII-IV）之间没有显着差异，p=0.08和p=0.67，分别。单变量分析确定了无进展生存期最低的性索组织学。多因素分析表明，体重指数（BMI）（HR=1.01；95％CI1.00至1.01）和性索组织学（HR=3.6；95％CI1.17至10.9）仍然是无进展生存的重要独立预后因素。总生存期的独立预后因素是BMI(HR=1.01;95%CI1.00~1.01)和残留病变(HR=7.16;95%CI1.39~36.97)。
结论：我们的研究表明BMI，残留病,和性索组织学是与45岁以下诊断为非上皮性卵巢癌的女性肿瘤预后较差相关的预后因素.尽管识别预后因素与识别高危患者和指导辅助治疗有关，与国际合作的大型研究对于阐明这种罕见疾病的肿瘤危险因素至关重要.
