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Chemotherapy alone for patients 75 years and older with epithelial ovarian cancer-is interval cytoreductive surgery still needed?
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Abstract:
BACKGROUND:Patients ≥75 years old with ovarian cancer experience high perioperative morbidity, but recruitment into prospective trials to assess the role of surgery continues to be challenging. OBJECTIVE:To compare overall survival for patients ≥75 years old with ovarian cancer after chemotherapy alone vs neoadjuvant chemotherapy with interval cytoreductive surgery. STUDY DESIGN:Data were extracted from the National Cancer Data Base from 2004 to 2014. Kaplan-Meier and Cox proportional hazards models were used for statistical analyses. RESULTS:Of 1661 patients (median age: 79 years), most were white (88%) and had stage III-IV disease (95%), and 51% had serous histology. Of those who did not receive primary surgery, 58% had chemotherapy alone and the remainder had neoadjuvant chemotherapy with interval cytoreductive surgery. The use of neoadjuvant chemotherapy with interval cytoreductive surgery increased from 28% to 50% in years 2004-2007 to 2012-2014 (P<.001). Compared with neoadjuvant chemotherapy with interval cytoreductive surgery, chemotherapy-only patients were older (80 vs 78 years; P<.001) and had more advanced stage disease (98% vs 91%; P<.001). The 5-year overall survival of the entire study group was 14%; those who underwent neoadjuvant chemotherapy with interval cytoreductive surgery had overall survival of 25% compared with only 7% in chemotherapy alone group (P<.001). In multivariable analysis, neoadjuvant chemotherapy with interval cytoreductive surgery (hazard ratio, 0.44; 95% confidence interval, 0.36-0.54; P<.001) was an independent predictor for improved survival. Older (80-84 years) age (hazard ratio, 1.35; 95% confidence interval, 1.12-1.63; P=.002), advanced (stage III-IV) disease (hazard ratio; 2.06, 95% confidence interval, 1.37-3.09; P=.001), and clear cell histology (hazard ratio; 2.17, 95% confidence interval, 1.10-4.28; P=.03) portended for worse outcome. CONCLUSION:Patients ≥75 years with ovarian cancer old have an overall poor prognosis. Receiving neoadjuvant chemotherapy followed by interval cytoreductive surgery is associated with greater overall survival compared to chemotherapy alone.
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
AM J OBSTET GYNECOL
| 最新影响因子：10.693 | 期刊ISSN：0002-9378 | CiteScore：3.5 |
| 出版周期：Monthly | 是否OA：YES | 出版年份：1920 |
期刊官方网址：http://www.ajog.org/
| 自引率：11.90% | 研究方向：医学-妇产科学 |
| 出版地区：UNITED STATES |
SCI期刊coverage：Science Citation Index Expanded（科学引文索引扩展）
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 期刊简介
英文简介：
The American Journal of Obstetrics and Gynecology, “The Gray Journal”, covers the full spectrum of Obstetrics and Gynecology. The aim of the Journal is to publish original research (clinical and translational), reviews, opinions, video clips, podcasts and interviews that will have an impact on the understanding of health and disease and that has the potential to change the practice of women's health care. An important focus is the diagnosis, treatment, prediction and prevention of obstetrical and gynecological disorders. The Journal also publishes work on the biology of reproduction, and content which provides insight into the physiology and mechanisms of obstetrical and gynecological diseases.
中文简介：（来自Google、百度翻译）
美国妇产科杂志，“灰色杂志”，涵盖了妇产科的所有领域。该杂志的目的是发表原创研究(临床和翻译)、评论、意见、视频剪辑、播客和访谈，这些将对健康和疾病的理解产生影响，并有可能改变妇女保健的做法。妇产科疾病的诊断、治疗、预测和预防是一个重要的研究重点。该杂志还出版了生殖生物学方面的著作，内容涉及妇产科疾病的生理学和机制。 好处的作者
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 期刊中科院评价数据
最新中科院分区
| 大类(学科) | 小类(学科) | 学科排名 |
| 医学 |
OBSTETRICS & GYNECOLOGY (妇产科学) 1区 |
2/82 |
最新公布的期刊年发文量
| 年度总发文量 | 年度论文发表量 | 年度综述发表量 |
| 343 | 310 | 33 |
总被引频次：40864
特征因子：0.049260
影响因子趋势图
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 期刊CiteScore评价数据
最新CiteScore值
3.5
=
引文计数(2018)
文献(2015-2017)
=
6254次引用
1788篇文献
文献总数（2014-2016）：1788
被引比率：70%
SJR：2.7
SCLmago期刊等级衡量经过加权后的期刊受引用次数，引用次数的加权值由施引期刊的学科领域和声望(SJR)决定。
SNIP：1.811
每篇文章中来源出版物的标准化影响将实际受引用情况对照期刊所属学科领域中预期的受引用情况进行衡量。
CiteScore排名
| 序号 | 类别 | 排名 | 百分位 |
| 1 |
大类(学科)：Medicine
小类(学科)：Obstetrics and Gynecology
|
#5/168
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最新评论(不代表本站观点)
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liting7111
研究方向：妇产科
写了篇流行病方向文章，同门的投稿都是一个月就审回，我两个月才审回，5个审稿人给了拒绝，但是可以修改后重投，大修再投两个月还是被拒了。2020-06-11 -
liting7111
研究方向：妇产科
审稿时间： 2个月内
9月1号投稿，10月7号通知拒稿。审稿速度块，审稿人意见也很有价值。2020-04-12 -
liting7111
研究方向：妇科肿瘤
审稿时间： 2个月内 接受率： 比较困难（25%命中）
审稿一个半月拒稿，不怎么好中，接受率20%2020-03-18 -
liting7111
研究方向：临床 流行病学 妇科学
审稿时间： 2个月内 接受率： 比较困难（25%命中）
投稿后竟然看不到状态，不过两个月后拒稿了，审稿人意见挺不错的。2020-02-15 -
liting7111
杂志收不收综述文章？2019-08-22 -
liting7111
研究方向：妇产科
审稿时间： 2个月内 接受率： 比较困难（25%命中）
之前投稿gynecology oncology被拒，按照意见修改后去年12月投稿，两个月修回，小修之后四个月接收，4月底在线，杂志还是偏临床。2019-05-12
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