UNASSIGNED:常规网膜切除术通常在上皮性卵巢癌(EOC)患者的手术期间进行。本研究旨在评估网膜切除术对I-IIIA期EOC患者病因特异性生存的影响。
未经证实:临床I-IIIA期浆液性患者,透明细胞,子宫内膜样,从SEER数据库中选择了2004年至2018年的粘液性卵巢癌.我们提取了临床病理数据和手术信息,重点是网膜切除术和淋巴结清扫术的表现。进行了二元逻辑回归和递归分区分析,以确定手术期间进行网膜切除术的重要因素。使用倾向评分匹配(PSM)和逆概率治疗加权(IPTW)技术来平衡混杂因素。多变量,我们进行了探索性亚组分析和敏感性分析,以评估网膜切除术对病因特异性生存率(CSS)的影响.
UNASSIGNED:共有13,302例EOC患者纳入研究。该队列包括3,569个子宫内膜样,4,915浆液,2,407透明电池,和2411个粘液性亚型。共有48.62%(6,467/13,302)的患者在初次手术期间接受了网膜切除术,在个人水平上,CSS只有3%的绝对改进,根据多变量分析无统计学意义。根据具有递归分区分析的回归树模型,淋巴结清扫术被认为是最强有力的因素来区分的表现,其次是肿瘤阶段。接受网膜切除术的患者比接受淋巴结切除术的患者更有可能在I期接受治疗。PSM-IPTW调整后,与未接受手术的患者相比,在初始手术中纳入网膜切除术未显示出对CSS的有益影响.探索性亚组分析表明,在II-IIIA期患者中,网膜切除术的表现改善了5年的CSS。在对不同肿瘤分期的敏感分析中,网膜切除术似乎仅对II期患者有益。然而,不同阶段的患者似乎受益于淋巴结清扫术,不管在他们身上进行了网膜切除术。
未经授权:常规网膜切除术可能与网膜外观大致正常的患者的生存获益无关,尤其是那些临床I期上皮性卵巢癌患者。
UNASSIGNED: Routine
omentectomy is generally performed during surgery for patients with epithelial ovarian cancer (EOC). The current study aims to evaluate the impact of
omentectomy on cause-specific survival of Stage I-IIIA EOC patients.
UNASSIGNED: Patients who presented with clinical Stage I-IIIA serous, clear cell, endometrioid, and mucinous ovarian cancers were selected from the SEER Database for the period between 2004 and 2018. We extracted clinicopathological data and surgical information with the focus on the performance of omentectomy and lymphadenectomy. Binary logistic regression and recursive partitioning analyses were conducted to identify the significant factors for the performance of omentectomy during surgery. Propensity score matching (PSM) and inverse probability treatment weighting (IPTW) techniques were utilized to balance confounding factors. Multivariate, exploratory subgroup analyses and sensitivity analyses were conducted to evaluate the impact of omentectomy on cause-specific survival (CSS).
UNASSIGNED: A total of 13,302 patients with EOC were enrolled in the study. The cohort comprised 3,569 endometrioid, 4,915 serous, 2,407 clear cell, and 2,411 mucinous subtypes. A total of 48.62% (6,467/13,302) of patients underwent the procedure of
omentectomy during primary surgery, and only 3% absolute improvement in CSS at the individual level was observed, without statistical significance based on multivariate analysis. According to the regression-tree model with recursive partitioning analysis, the procedure of lymphadenectomy was found to be the strongest factor to distinguish the performance of omentectomy, followed by the tumor stage. Patients who underwent
omentectomy were more likely to be managed in Stage I than those who underwent lymphadenectomy. After PSM-IPTW adjustment, the inclusion of omentectomy in the initial surgical procedure did not demonstrate a beneficial impact on CSS compared with those who did not undergo the procedure. Exploratory subgroup analysis indicated that the performance of
omentectomy improved 5-year CSS in Stage II-IIIA patients. In the sensitive analyses for various tumor stages, omentectomy appeared to benefit only Stage II patients. However, patients across various stages seemed to benefit from the performance of lymphadenectomy, irrespective of the performance of omentectomy on them.
UNASSIGNED: Routine omentectomy may not be associated with survival benefit for patients with a grossly normal-appearing omentum, especially for those with clinical Stage I epithelial ovarian cancers.