Tumor Type and Substage Predict Survival in Stage I and II Ovarian Carcinoma: Insights and Implications
Notice bibliographique
Résumé
Tumor grade has been the most accepted prognostic indicator of disease-specific survival among women with stage I and II ovarian carcinomas. Many investigators have included stage IB, grade 1 at diagnosis as low-risk disease and have suggested that women in this category should not receive adjuvant therapy. However, grading assignment appears to be unreliable because of problems with reproducibility and lack of consideration of biological differences between the different tumor types. Some investigators believe that classification based on tumor typing using new histopathological criteria was more reproducible than grade assignment and would more accurately reflect biological differences. This population-based cohort study evaluated the effectiveness of updated tumor type to predict outcome for patients with low-stage ovarian carcinoma at low risk of death. Between 1984 and 2003, 1326 women with a diagnosis of stage I–II ovarian carcinoma were referred to the British Columbia Cancer Agency. Of these, 652 (49%) were available for full slide review. Type and grade were assessed using contemporary histopathological criteria. Tumor types investigated accounting for 98% of ovarian carcinomas included high-grade serous, endometrioid, clear cell, mucinous, and low-grade serous. Of the 630 cases confirmed as ovarian carcinomas, 25 were rare types and were excluded, leaving 605 cases available for the final analysis. Outcomes among different subtypes were assessed using univariate models and recursive partitioning analysis. An excellent outcome (low risk of death) was defined as a disease-specific survival at 10 years (DSS10y) ≥95%. There was an excellent outcome in 77 cases with ovarian carcinomas of endometrioid and mucinous type, stage IA or IB. The outcome for high-grade serous carcinomas was poor (DSS10y = 57%); no subset could be identified with an excellent outcome. Although no subsets of clear cell carcinomas had an excellent outcome, a small group of patients with stage IA or IB tumors had a more favorable outcome (DSS10y = 87%) compared to those with stage IC–II (DSS10y = 66%). These findings indicate that tumor type is superior to grade in identifying the risk of death from ovarian carcinoma among women with stage I/II disease. Classification of all stage IA or IB endometrioid and mucinous ovarian carcinomas at time of presentation as low-risk would allow the proportion of patients for which adjuvant treatment could be avoided to be increased from 6.5% to 12.2%.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».