Adjuvant Chemotherapy for Stage I Clear Cell Carcinoma of the Ovary

Takada, Toshio; Iwase, Haruko; Iitsuka, Chiaki; Nomura, Hidetaka; Sakamoto, Kimihiko; Omatsu, Kohei; Takeshima, Nobuhiro; Takizawa, Ken

doi:10.1097/igc.0b013e31823fd413

Cited by 38 publications

(29 citation statements)

References 16 publications

(6 reference statements)

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“…However, early stage CCC confined within the ovary has excellent prognosis, 95% survival for surgical stage IA disease [12]. A retrospective study with 73 patients with CCC by Takada et al showed that postoperative adjuvant chemotherapy might not be necessary for stage IA CCC patients [21]. However, current evidence is not strong enough to change the treatment guidelines, which recommend that all patients with CCC, including stage IA or IB disease, receive postoperative adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 98%

The clinical value of surgeons' efforts of preventing intraoperative tumor rupture in stage I clear cell carcinoma of the ovary: A Korean multicenter study

Suh

Lee

Lim

et al. 2015

Gynecologic Oncology

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Section: Discussionmentioning

confidence: 98%

The clinical value of surgeons' efforts of preventing intraoperative tumor rupture in stage I clear cell carcinoma of the ovary: A Korean multicenter study

Suh

Lee

Lim

et al. 2015

Gynecologic Oncology

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“…It is important to note, however, that because of the small numbers, these data can be incorporated into a risks-and-benefits discussion but do not replace standard staging guidelines. Takada et al 13 published survival and recurrence data on 73 patients with stage I OCCC who were comprehensively staged during a 9-year study period. On multivariate analysis, positive washings and/or ovarian surface involvement were independently related to both overall survival and progression-free survival regardless of adjuvant treatment.…”

Section: Discussionmentioning

confidence: 99%

Staging Lymphadenectomy in Patients With Clear Cell Carcinoma of the Ovary

Mueller

Holzapfel

Han

et al. 2016

Int J Gynecol Cancer

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Objective The purpose of this study was to assess the rate of lymph node (LN) metastasis in comprehensively staged ovarian clear cell carcinoma (OCCC) clinically confined to the ovary and determine factors associated with LN metastasis. Methods We identified all cases of OCCC treated at four institutions from January 1994 through December 2011. We included cases with disease grossly confined to the ovary that had surgical staging performed, including at least 10 LNs sampled. Clinical and pathologic data were abstracted from electronic medical records and a de-identified data set was compiled and processed at a single institution. Factors potentially associated with LN metastasis were tested. Appropriate statistical tests were performed. Results We identified 145 eligible cases that met the criteria for this analysis. Median age was 52.9 years (range, 30–81), and median total LN count was 19 (range, 10–74). Seven (4.8%) of 145 comprehensively staged cases had LN metastasis; 6 of these cases (4.1%) were isolated metastasis. Cytologic washings, peritoneal, omental and fallopian tube involvement were not associated with nodal metastasis. Cases with ovarian surface involvement and positive cytology had a 37.5% incidence of LN positivity, which was statistically meaningful when compared with all other cases (p=0.003). Conclusion Women who underwent comprehensive staging for clinical stage I OCCC had a LN metastasis rate of 4.8%. The subgroup of cases with both ovarian surface involvement and positive cytology had the highest incidence of LN metastasis. This may influence clinical decision making on whether to perform lymphadenectomy in patients with incidental OCCC found after salpingo-oophorectomy.

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“…Mizuno et al 16 reported that the 5-year RFS rates in CCC patients who received comprehensive surgical staging and were treated with/ without adjuvant chemotherapy were 93.8% (n = 16) and 100% (n = 25) for stage IA, and 86.6% (n = 75) and 94.1% (n = 18) for stage IC1, respectively, and concluded the routine adjuvant chemotherapy after comprehensive surgical staging may be unnecessary for patients with at least stage IA. Takada et al 23 reported outcome of stage I CCC patients who received comprehensive surgical staging consisting of 4 with stage IA and 11 with stage IC1 who received adjuvant chemotherapy and 16 with stage IA and 16 with stage IC1 who received no additional therapy. It was reported that no recurrence was observed in stage IA patients and that the 5-year RFS and OS rates in stage IC1 patients were 87.5% and 100% in the adjuvant chemotherapy group and 74.0% and 76.4% in the observation group, respectively, and suggested that postoperative adjuvant chemotherapy is not necessary for stage IA CCC patients but that adjuvant chemotherapy suppressed recurrence for stage IC CCC.…”

Section: Discussionmentioning

confidence: 99%