Long-term outcomes of patients with International Federation of Gynecology and Obstetrics stage Ⅳ ovarian high-grade serous carcinoma and correlated influencing factors

Cai Yan; Shu Tong; Zheng Hong

doi:10.3760/j.issn.1673-4777.2023.12.019

Abstract：Objective To investigate long-term outcomes of patients with International Federation of Gynecology and Obstetrics(FIGO)stage Ⅳ ovarian high-grade serous carcinoma(HGSOC)and correlated influencing factors.Methods Clinical data of patients with FIGO stage Ⅳ HGSOC admitted to Beijing Cancer Hospital from January 2010 to December 2020 were collected retrospectively.Patients were divided into primary debulking surgery(PDS)group,interval debulking surgery(IDS)group,and chemotherapy alone group according to the treatment approaches.The overall survival and correlated influencing factors were analyzed.Results Totally 125 patients were enrolled in this study,including 21 cases in the PDS group,91 cases in the IDS group and 13 cases in the chemotherapy alone group.There were significant differences in age and carbohydrate antigens level among the three groups(both P＜0.05).There were significant differences in surgical complexity score and the proportion of upper abdominal surgery between the PDS group and the IDS group(both P＜0.05).The medium overall survival in the PDS group,IDS group and chemotherapy alone group was 70,56 and 25 months,respectively,and the difference was statistically significant(P＜0.001).Stratified analysis based on FIGO staging showed that the medium overall survival of patients with stage Ⅳ A was shorter than patients with stage Ⅳ B(49 months vs 59 months,P=0.013).Multivariate Cox analysis showed that initial treatment,application of polyadenosine diphosphate ridose polymerase(PARP)inhibitors,and postoperative tumor remnant were independent factors influencing the overall survival of patients with stage Ⅳ ovarian HGSOC(all P＜0.05).Conclusions Debulking surgery improves outcomes for patients with stage Ⅳ ovarian HGSOC,and the initial treatment,application of PARP inhibitors,and postoperative tumor remnant are independent factors influencing the overall survival.