Prediction of the survival of patients with advanced‐stage ovarian cancer patients undergoing interval cytoreduction with the use of computed tomography reevaluation after neoadjuvant chemotherapy

医学 比例危险模型 卵巢癌 单变量分析 危险系数 阶段(地层学) 化疗 生存分析 回顾性队列研究 放射科 多元分析 肿瘤科 癌症 外科 内科学 置信区间 古生物学 生物
作者
Jia‐Yi Li,Rui Wang
出处
期刊:Journal of Obstetrics and Gynaecology Research [Wiley]
卷期号:49 (11): 2700-2710 被引量:1
标识
DOI:10.1111/jog.15760
摘要

To predict ovarian cancer patients' survival by computed tomography (CT) reevaluation after neoadjuvant chemotherapy.In this retrospective single-center cohort study, all patients with advanced epithelial ovarian cancer underwent platinum-based chemotherapy followed by interval cytoreductive surgery. Assessment of abdominal and pelvic lesions before and after chemotherapy using CT scoring criteria. Meanwhile, the progression-free survival and overall survival times were obtained. The Kaplan-Meier method was used to estimate survival curves. Univariate analysis of continuous and categorical variables was performed for prognostic significance using the Cox proportional hazards model. Variables with p < 0.10 on univariate analysis were then included in a multivariate forward stepwise Cox regression analysis.A total of 162 patients were included, with a median age of 52 years (range, 20-72 years). One hundred seven patients (66.0%) underwent suboptimal cytoreduction, and there was no statistically significant difference in patient survival between surgical procedures (log-rank p = 0.092). Six radiographic features were hazard factors for suboptimal cytoreduction. Four features in the postchemotherapy CT images were assigned as predictive criteria by the stepwise regression model (area under the curve [AUC] = 0.689). As compared with a higher AUC (0.713) in the model involving two clinical variables (age and postsurgery CA-125) and two postchemotherapy CT features, the model considering the CT score changes before and after chemotherapy had the highest diagnostic accuracy (AUC = 0.843).CT reevaluation after neoadjuvant chemotherapy is essential for ovarian cancer, the changes of CT feature and score are potential great tools to predict patient survival.
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