Artículos de revistas
Serous And Non-serous Ovarian Carcinoma: Histological Tumor Type As Related To The Grade Of Differentiation And Disease Prognosis [carcinoma De Ovário Seroso E Não Seroso: Tipo Histológico Em Relação Ao Grau De Diferenciação E Prognóstico]
Registro en:
Revista Brasileira De Ginecologia E Obstetricia. , v. 34, n. 5, p. 196 - 202, 2012.
1007203
2-s2.0-84862096338
Autor
Ferreira P.A.R.
Sallum L.F.T.A.
Sarian L.O.
Andrade L.A.L.A.
Derchain S.
Institución
Resumen
PURPOSE: To compare the clinical-pathological features of women with serous and non-serous ovarian tumors and to identify the factors associated with survival. METHODS: In this reconstructed cohort study, 152 women with ovarian carcinoma, who attended medical consultations between 1993 and 2008 and who were followed-up until 2010 were included. The histological type was clearly established for all women: 81 serous carcinomas and 71 non-serous tumors (17 endometrioid, 44 mucinous and 10 clear cell carcinomas). The crude and adjusted odds ratios (OR), with the respective 95% confidence intervals (95%CI), were calculated for the clinical and pathological features, comparing serous and non-serous histological types. The Hazard Ratios (HR) with 95%CI was calculated for overall survival, considering the clinical and pathological features. RESULTS: Comparison of serous to non-serous tumor types by univariate analysis revealed that serous tumors were more frequently found in postmenopausal women, and were predominantly high histological grade (G2 and G3), advanced stage, with CA125>250 U/mL, and with positive peritoneal cytology. After multivariate regression, the only association remaining was that of high histological grade with serous tumors (adjusted OR 15.1; 95%CI 2.9-77.9). We observed 58 deaths from the disease. There was no difference in overall survival between women with serous carcinoma and women with non-serous carcinoma (HR 0.4; 95%CI 0.1 - 1.1). It was observed that women aged 50 years or less (HR 0.4; 95%CI 0.1-0.9) and those who were in menacne (HR 0.3; 95%CI 0.1-0.9) had a longer survival compared respectively to those above 50 years of age and menopaused. High histological grade (G2 and G3) (p<0.01), stages II-IV (p<0.008) and positive cytology (p<0.001) were significantly associated with worse prognosis. CA125 and the presence of ascites did not correlate with survival. Survival was poor when the disease was diagnosed in stages II to IV and compared to stage I (log-rank p<0.01) regardless of histological type (serous and non-serous). CONCLUSIONS: The proportion of high histological grade (G2 and G3) was significantly higher among serous than non-serous carcinomas. Serous and non-serous histological types were not related to overall survival. 34 5 196 202 (2012) Cancer facts and figures 2008, , http://www.cancer.org/acs/groups/content/@nho/documents/document/2008cafffinalsecuredpdf.pdf, American Cancer Society [Internet] Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., Murray, T., Cancer statistics, 2008 (2008) CA Cancer J Clin, 58 (2), pp. 71-96 Coordenação Nacional De Prevenção E Vigilância Do Câncer http://www1.inca.gov.br/regpop/2003/index.asp?=conteudo_view.asp&ID=10, Brasil. Ministério da Saúde. Instituto Nacional do Câncer (INCA), [Internet]. Câncer no Brasil: dados dos registros de base populacional. Rio de Janeiro 2003 [cited 2012 Jan 3]. Available fromSoslow, R.A., Histologic subtypes of ovarian carcinoma: An overview (2008) Int J Gynecol Pathol, 27 (2), pp. 161-174 Bell, D.A., Origins and molecular pathology of ovarian cancer (2005) Mod Pathol, 18 (2 SUPPL.), pp. S19-S32 Ayhan, A., Kurman, R.J., Yemelyanova, A., Vang, R., Logani, S., Seidman, J.D., Defining the cut point between low-grade and high-grade ovarian serous carcinomas: A clinicopathologic and molecular genetic analysis (2009) Am J Surg Pathol, 33 (8), pp. 1220-1224 Diniz, P.M., Carvalho, J.P., Baracat, E.C., Carvalho, F.M., Fallopian tube origin of supposed ovarian high-grade serous carcinomas (2011) Clinics, 66 (1), pp. 73-76 Kurman, R.J., Shih, I.M., The origin and pathogenesis of epithelial ovarian cancer: A proposed unifying theory (2010) Am J Surg Pathol, 34 (3), pp. 433-443 Tazi, E.M., Lalya, I., Tazi, M.F., Ahellal, Y., M'Rabti, H., Errihani, H., Transitional cell carcinoma of the ovary: A rare case and review of literature (2010) World J Surg Oncol, 14 (8), p. 98 McCluggage, W.G., Morphological subtypes of ovarian carcinoma: A review with emphasis on new developments and pathogenesis (2011) Pathology, 43 (5), pp. 420-432 Farley, J., Ozbun, L.L., Birrer, M.J., Genomic analysis of epithelial ovarian cancer (2008) Cell Res, 18 (5), pp. 538-548 Brun, J.L., Feyler, A., Chêne, G., Saurel, J., Brun, G., Hocké, C., Long-term results and prognostic factors in patients with epithelial ovarian cancer (2000) Gynecol Oncol, 78 (1), pp. 21-27 Hosono, S., Kajiyama, H., Mizuno, K., Sakakibara, K., Matsuzawa, K., Takeda, A., Comparison between serous and non-serous ovarian cancer as a prognostic factor in advanced epithelial ovarian carcinoma after primary debulking surgery (2011) Int J Clin Oncol, 16 (5), pp. 524-532 Winter III, W.E., Maxwell, G.L., Tian, C., Carlson, J.W., Ozols, R.F., Rose, P.G., Prognostic factors for stage III epithelial ovarian cancer: A Gynecologic Oncology Group Study (2007) J Clin Oncol, 25 (24), pp. 3621-3627 Brun, J.L., Bouzigon, E., Saurel, J., Chêne, G., Briex, M., Brun, G., Prognostic factors for survival of ovarian epithelial cancers: A propos of 287 cases (2000) Gynecol Obstet Fertil, 28 (3), pp. 223-231 Makar, A.P., Baekelandt, M., Tropé, C.G., Kristensen, G.B., The prognostic significance of residual disease, FIGO substage, tumor histology, and grade in patients with FIGO stage III ovarian cancer (1995) Gynecol Oncol, 56 (2), pp. 175-180 Benedet, J.L., Bender, H., Jones III, H., Ngan, H.Y., Pecorelli, S., FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology (2000) Int J Gynaecol Obstet, 70 (2), pp. 209-262 (2004) R: A Language and Environment For Statistical Computing [Internet], , http://R-project.org, R Development Core Team, Vienna: R Foundation for Statistical Computing, [cited 2011 Apr 5]. Available from Canevari, S., Gariboldi, M., Reid, J.F., Bongarzone, I., Pierotti, M.A., Molecular predictors of response and outcome in ovarian cancer (2006) Crit Rev Oncol Hematol, 60 (1), pp. 19-37 Chan, J.K., Tian, C., Monk, B.J., Herzog, T., Kapp, D.S., Bell, J., Prognostic factors for high-risk early-stage epithelial ovarian cancer: A Gynecologic Oncology Group Study (2008) Cancer, 112 (10), pp. 2202-2210 Chan, J.K., Loizzi, V., Lin, Y.G., Osann, K., Brewster, W.R., Disaia, P.J., Stages III and IV invasive ephitelial ovarian carcinoma in younger versus older women: What prognostic factors are important? (2003) Obstet Gynecol, 102 (1), pp. 156-161 Chan, J.K., Urban, R., Cheung, M.K., Osann, K., Shin, J.Y., Husain, A., Ovarian cancer in younger vs older women: A population-based analysis (2006) Br J Cancer, 95 (10), pp. 1314-1320 Vergote, I., de Brabanter, J., Fyles, A., Bertelsen, K., Einhorn, N., Sevelda, P., Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma (2001) Lancet, 357 (9251), pp. 176-182 Weir, H.K., Thun, M.J., Hankey, B.F., Ries, L.A., Howe, H.L., Wingo, P.A., Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control (2003) J Natl Cancer Inst, 95 (17), pp. 1276-1299 Aletti, G.D., Gallenberg, M.M., Cliby, W.A., Jatoi, A., Hartmann, L.C., Current management strategies for ovarian cancer (2007) Mayo Clin Proc, 82 (6), pp. 751-770 Permuth-Wey, J., Sellers, T.A., Epidemiology of ovarian cancer (2009) Methods Mol Biol, 472, pp. 413-437