目的:我们进行了一项多机构观察性研究,以研究低级别晚期卵巢癌(LGSOC)初级治疗后的维持激素治疗是否与总体生存优势相关。
方法:我们纳入了2004年1月1日至2019年12月31日之间诊断为组织学确诊的III期或IV期LGSOC患者,在美国癌症委员会认可的癌症项目中接受治疗。在诊断后6个月内接受激素治疗的患者与在该时间段内没有开始激素治疗的对照者通过风险集倾向评分匹配进行匹配。主要结果是在开始HT或观察后五年内因任何原因死亡的风险。
结果:有296名患者在诊断后6个月内开始了维持激素治疗,有2805名潜在的对照组。接受激素治疗的患者更常在学术医疗中心接受治疗(55%vs.44%),在研究期间晚些时候诊断(62%vs.23%在2018-2019年被诊断),并且在初始治疗期间经常没有接受化疗(45%vs.17%)。风险集倾向评分匹配后,我们确定了225例接受HT治疗的患者和225例未经治疗的对照,这些患者在测量的协变量方面相似.在匹配的队列中,激素治疗与死亡风险降低相关(风险比0.60;95%CI0.38-0.94),对应的60个月生存率为75%,而65%。
结论:在LGSOC的初级管理之后,与观察相比,维持激素治疗与总生存期改善相关.
OBJECTIVE: We conducted a multi-institutional observational study to investigate whether maintenance hormone therapy following primary treatment of low-grade advanced-stage ovarian cancer (LGSOC) is associated with an overall survival advantage.
METHODS: We included patients with histologically confirmed stage III or IV LGSOC diagnosed between Jan 1, 2004, and Dec 31, 2019, treated in Commission on Cancer-accredited cancer programs in the US. Patients who received hormone therapy within six months of diagnosis were matched to controls who did not initiate hormone therapy during this timeframe by risk-set propensity score matching. The primary outcome was the risk of death from any cause within five years of initiation of HT or observation.
RESULTS: There were 296 patients who initiated maintenance hormone therapy within six months of diagnosis and 2805 potential controls. Patients who received hormone therapy were more often treated in academic medical centers (55% vs. 44%), diagnosed later in the study period (62% vs. 23% diagnosed in 2018-2019), and frequently received no chemotherapy during initial treatment (45% vs. 17%). After risk set propensity score matching, we identified 225 patients treated with HT and 225 untreated controls who were otherwise similar with respect to measured covariates. In the matched cohort, hormone therapy was associated with a reduction in the risk of death (hazard ratio 0.60; 95% CI 0.38-0.94), corresponding to a 60-month survival of 75% compared with 65%.
CONCLUSIONS: Following primary management of LGSOC, maintenance hormone therapy was associated with improved overall survival compared with observation.