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Purpose: To evaluate the impact of surgical compliance on overall survival (OS) and cancer-specific survival (CSS) in ovarian cancer patients and identify factors influencing surgical compliance. Materials and methods: Data from patients with ovarian cancer in the SEER database (2004-2015) were analyzed to compare the characteristics of patients with high and low surgical compliance. Kaplan-Meier curves and Cox regression models were used to assess the impact of surgical compliance on survival outcomes. Nomograms incorporating surgical compliance and independent prognostic factors were constructed to predict OS and CSS and were validated using internal validation sets. Predictive accuracy was evaluated using Harrell's concordance index (C-index), decision curve analysis (DCA), receiver operating characteristic (ROC) curves, and calibration plots. Binary logistic regression analysis identified factors significantly affecting surgical compliance, and propensity score matching (PSM) was used to adjust for confounders. Results: Among the 41,859 patients, 783 (1.87 %) demonstrated poor surgical compliance, while 41,076 (98.13 %) exhibited good compliance. Surgical compliance has emerged as an independent prognostic indicator for ovarian cancer. Patients with high compliance had significantly better OS and CSS rates (P < 0.0001). The prognostic models were internally validated and showed strong discriminative and calibration capabilities. Factors affecting compliance included older age, advanced pathological stage, metastasis, elevated CA-125 levels, and lower income. After PSM, Kaplan-Meier analysis revealed significantly improved survival in patients with good compliance (P < 0.0001). Conclusion: Surgical compliance is a pivotal and independent predictor of overall and cancer-specific survival in patients undergoing OC. Factors contributing to lower surgical compliance include advanced age, later tumor stage, metastatic spread, elevated CA-125 levels, and reduced family income.
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OBJECTIVE: Ovarian cancer (OC) is a common malignant tumor in females with high recurrence and poor prognosis. Cisplatin is commonly used for OC clinical treatment, but its efficacy is usually challenged by the chemotherapy resistance of cancer cells. MicroRNAs (miRNAs), including miR-30a-5p, were identified to modulate drug resistance in numerous tumors. However, molecular mechanisms of miR-30a-5p in OC chemoresistance need more illumination. METHODS: MiR-30a-5p and Rap1 interacting factor 1 (RIF1) expression in OC tissues and cells were measured by qRT-PCR. The IC50 of cisplatin-resistant and cisplatin-sensitive OC cells was assessed by MTT assays. OC cell proliferation, apoptosis and migration were measured by EdU assays, TUNEL staining, and wound healing assays, respectively. The protein levels of EMT markers and RIF1 in OC cells were examined by western blotting. The binding capacity between miR-30a-5p and RIF1 was validated by luciferase reporter assays. RESULTS: Our study disclosed miR-30a-5p as a remarkably lowly-expressed miRNA in OC tissues in comparison to matched noncancerous tissues. Compared to parental cell lines, miR-30a-5p was also greatly downregulated in cisplatin-resistant OC cell lines. Additionally, functional assays indicated that miR-30a-5p suppressed malignant behaviors and cisplatin resistance of OC cells. Further, miR-30a-5p was revealed to target and negatively regulate RIF1 expression in OC. Moreover, it was validated that overexpressing RIF1 reverses the inhibitory influence of miR-30a-5p overexpression on malignant behaviors and cisplatin resistance of OC cells. CONCLUSION: MiR-30a-5p reduced cisplatin resistance in OC through downregulation of RIF1, which may be meaningful for targeting drug-resistant tumors.