Objective: The sepsis-induced inflammatory response may potentially affect malignant cells. Recently, a case of spontaneous regression of a histologically confirmed International Federation of Gynecology and Obstetrics (FIGO) stage IIIC epithelial ovarian cancer (EOC) following sepsis was reported. The aim of our study was to assess the impact of sepsis on the oncologic outcomes of advanced-stage EOC patients. Methods: Gynecologic oncologic patients admitted to the Intensive Care Unit of three oncologic centers between 2006 and 2019 were identified and patients who experienced sepsis following advanced-stage EOC diagnosis were selected. Survival outcomes were compared with advanced-stage EOC patients from the Netherlands Cancer Registry (NCR). To correct for case-mix differences, propensity score matching using 1:3 nearest neighbor matching was conducted after which survival analyses were repeated. Results: A total of 18 of 215 patients with advanced-stage EOC experienced sepsis. Sepsis patients had similar distributions of patient, tumor, and treatment characteristics to 3988 patients from the NCR cohort. A total of 3 of 18 patients died from the complications of sepsis. While the remaining patients initially responded to treatment, 14/15 patients relapsed. The median (IQR) overall survival was 31 (24–44) and 35 (20–60) months for the sepsis and unmatched NCR cohort (p= 0.56), respectively. The median (IQR) progression-free survival was 16 (11–21) and 16 (11–27) months (p= 0.90), respectively. Survival outcomes did not differ following propensity matching (overall survival of 31 (24–44) vs. 36 (20–56) months,p= 0.40; progression-free survival of 16 (11–21) and 16 (12–21) months,p= 0.72). Conclusion: In this observational study, the occurrence of sepsis did not affect the oncologic and survival outcomes of advanced-stage EOC patients.
目的：脓毒症引发的炎症反应可能对恶性肿瘤细胞产生影响。近期有文献报道一例经组织学确诊的国际妇产科联盟（FIGO）IIIC期上皮性卵巢癌患者在发生脓毒症后出现肿瘤自发消退现象。本研究旨在评估脓毒症对晚期上皮性卵巢癌患者肿瘤学预后的影响。方法：通过检索2006年至2019年间三家肿瘤中心重症监护病房收治的妇科肿瘤患者，筛选出晚期上皮性卵巢癌确诊后发生脓毒症的病例。将生存结局与荷兰癌症登记处（NCR）的晚期上皮性卵巢癌患者队列进行对比。为校正病例特征差异，采用1:3最近邻匹配法进行倾向评分匹配后重复生存分析。结果：215例晚期上皮性卵巢癌患者中，共18例发生脓毒症。脓毒症组患者的人口学特征、肿瘤特征及治疗特征分布与NCR队列3988例患者相似。18例脓毒症患者中3例死于脓毒症并发症。其余患者虽对初始治疗有反应，但15例中有14例出现疾病复发。脓毒症组与未匹配NCR队列的中位总生存期（四分位距）分别为31（24-44）个月和35（20-60）个月（p=0.56），中位无进展生存期分别为16（11-21）个月和16（11-27）个月（p=0.90）。倾向匹配后生存结局仍无显著差异（总生存期：31（24-44）个月 vs 36（20-56）个月，p=0.40；无进展生存期：16（11-21）个月 vs 16（12-21）个月，p=0.72）。结论：本观察性研究表明，脓毒症的发生未对晚期上皮性卵巢癌患者的肿瘤学结局及生存预后产生显著影响。
肿瘤(癌症)患者之家