Abstract：
BACKGROUND: Ovarian clear cell carcinoma (OCCC) is a rare pathological type of ovarian cancer with a poor prognosis, and lymphadenectomy is controversial in patients with OCCC. The objective of this study was to evaluate the impact of lymphadenectomy on the prognosis of patients with OCCC.
METHODS: In this retrospective study, we collected data from the Surveillance, Epidemiology and End Results (SEER) database and institutional registries in China. The SEER cohort included 1777 women diagnosed with OCCC between 2010 and 2019, while the Chinese cohort included 199 women diagnosed between April 2004 and April 2021. Recurrence-free survival (RFS) and overall survival (OS) were studied using Kaplan-Meier curve and Cox regression analysis. We also employed propensity score matching (PSM) to adjust for baseline imbalances between the lymphadenectomy group and the no-lymphadenectomy group.
RESULTS: Multivariate cox regression analysis showed that lymphadenectomy was not associated with better overall survival (OS) in either early (hazard ratio [HR] 0.84[0.50-1.43], p = 0.528) or advanced (HR 0.78[0.50-1.21], p = 0.270) patients in the SEER cohort after PSM. Additionally, in the Kaplan-Meier curve analysis, lymphadenectomy did not significantly improve OS in both early (p = 0.28) and advanced (p = 0.49) patients in the SEER cohort after PSM. Similarly, in the Chinese cohort, lymphadenectomy had no significant effect on OS (early p = 0.22; advanced p = 0.61) or RFS (early p = 0.18; advanced p = 0.83) in both early and advanced patients.
CONCLUSIONS: In completely homogeneous groups, lymphadenectomy in women diagnosed with OCCC had no effect on either recurrence-free survival or overall survival compared to patients without lymphadenectomy.
METHODS: In this retrospective study, we collected data from the Surveillance, Epidemiology and End Results (SEER) database and institutional registries in China. The SEER cohort included 1777 women diagnosed with OCCC between 2010 and 2019, while the Chinese cohort included 199 women diagnosed between April 2004 and April 2021. Recurrence-free survival (RFS) and overall survival (OS) were studied using Kaplan-Meier curve and Cox regression analysis. We also employed propensity score matching (PSM) to adjust for baseline imbalances between the lymphadenectomy group and the no-lymphadenectomy group.
RESULTS: Multivariate cox regression analysis showed that lymphadenectomy was not associated with better overall survival (OS) in either early (hazard ratio [HR] 0.84[0.50-1.43], p = 0.528) or advanced (HR 0.78[0.50-1.21], p = 0.270) patients in the SEER cohort after PSM. Additionally, in the Kaplan-Meier curve analysis, lymphadenectomy did not significantly improve OS in both early (p = 0.28) and advanced (p = 0.49) patients in the SEER cohort after PSM. Similarly, in the Chinese cohort, lymphadenectomy had no significant effect on OS (early p = 0.22; advanced p = 0.61) or RFS (early p = 0.18; advanced p = 0.83) in both early and advanced patients.
CONCLUSIONS: In completely homogeneous groups, lymphadenectomy in women diagnosed with OCCC had no effect on either recurrence-free survival or overall survival compared to patients without lymphadenectomy.
摘要：
背景：卵巢透明细胞癌（OCCC）是一种罕见的卵巢癌病理类型，预后较差。淋巴结清扫术在OCCC患者中存在争议。本研究的目的是评估淋巴结清扫术对OCCC患者预后的影响。
方法：在这项回顾性研究中，我们从监控中收集了数据,中国流行病学和最终结果(SEER)数据库和机构注册。SEER队列包括2010年至2019年诊断为OCCC的1777名女性，而中国队列包括2004年4月至2021年4月诊断为OCCC的199名女性。采用Kaplan-Meier曲线和Cox回归分析研究无复发生存期(RFS)和总生存期(OS)。我们还采用倾向评分匹配（PSM）来调整淋巴结清扫组和非淋巴结清扫组之间的基线失衡。
结果：多变量cox回归分析显示，淋巴结清扫术与较好的早期总生存期（OS）无关（风险比[HR]0.84[0.50-1.43]，p=0.528)或高级(HR0.78[0.50-1.21]，p=0.270）PSM后SEER队列中的患者。此外,在卡普兰-迈耶曲线分析中，在PSM后的SEER队列中,淋巴结清扫术对早期(p=0.28)和晚期(p=0.49)患者的OS均无显著改善.同样，在中国队列中，在早期和晚期患者中，淋巴结清扫术对OS（早期p=0.22；晚期p=0.61）或RFS（早期p=0.18；晚期p=0.83）均无明显影响。
结论：在完全同质的组中，与未行淋巴结清扫术的患者相比,诊断为OCCC的女性行淋巴结清扫术对无复发生存率或总生存率均无影响.
方法：在这项回顾性研究中，我们从监控中收集了数据,中国流行病学和最终结果(SEER)数据库和机构注册。SEER队列包括2010年至2019年诊断为OCCC的1777名女性，而中国队列包括2004年4月至2021年4月诊断为OCCC的199名女性。采用Kaplan-Meier曲线和Cox回归分析研究无复发生存期(RFS)和总生存期(OS)。我们还采用倾向评分匹配（PSM）来调整淋巴结清扫组和非淋巴结清扫组之间的基线失衡。
结果：多变量cox回归分析显示，淋巴结清扫术与较好的早期总生存期（OS）无关（风险比[HR]0.84[0.50-1.43]，p=0.528)或高级(HR0.78[0.50-1.21]，p=0.270）PSM后SEER队列中的患者。此外,在卡普兰-迈耶曲线分析中，在PSM后的SEER队列中,淋巴结清扫术对早期(p=0.28)和晚期(p=0.49)患者的OS均无显著改善.同样，在中国队列中，在早期和晚期患者中，淋巴结清扫术对OS（早期p=0.22；晚期p=0.61）或RFS（早期p=0.18；晚期p=0.83）均无明显影响。
结论：在完全同质的组中，与未行淋巴结清扫术的患者相比,诊断为OCCC的女性行淋巴结清扫术对无复发生存率或总生存率均无影响.
