Significance of Ovarian Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma

Park, Jeong-Yeol; Kim, Dae-Yeon; Suh, Dae-Shik; Kim, Jong-Hyeok; Kim, Yong‐Man; Kim, Young‐Tak; Nam, Joo‐Hyun

doi:10.1097/igc.0000000000001136

Cited by 43 publications

(27 citation statements)

References 15 publications

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“…OCCC with endometriosis has been reported to be associated with early stage and good prognosis [16,17]. Meanwhile no difference in prognosis of OCCC according to the presence of endometriosis has been reported [18,19]. In the present study, about one-third of patients had endometriosis.…”

Section: Discussioncontrasting

confidence: 43%

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea

et al. 2020

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The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in early stage. Materials and Methods Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected. Results Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease  1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence. Conclusion Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.

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Section: Discussioncontrasting

confidence: 43%

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea

et al. 2020

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“…OCCC with endometriosis has been reported to be associated with early stage and good prognosis [16,17]. Meanwhile no difference in prognosis of OCCC according the presence of endometriosis has been reported [18,19]. In the present study, about one third of patients had endometriosis.…”

Section: Discussioncontrasting

confidence: 42%

Clinical characteristics of clear cell ovarian cancer: A retrospective multicenter experience of 308 patients in South Korea.

Lee

Hong

Byun

et al. 2019

JCO

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e17062 Background: Clear cell ovarian cancer is rare, accounts for about 3-10% of epithelial ovarian carcinoma, and is known to be associated with endometriosis. This tumor type has poor prognosis due to inherent chemoresistance. We investigated clinical characteristics and prognostic factors of clear cell ovarian cancer in South Korea. Methods: We reviewed the medical records of 308 patients with clear cell histology ovarian cancer who underwent debulking surgery from 21 institutions in South Korea between 1995 and 2015. Results: Mean age was 51 years (range, 25-81) and 194 patients (63.7%) had stage I disease, 34 (11.1%) had stage II, 66 (21.6%) had stage III, and 11 (3.6%) had stage IV. 107 patients (34.9%) had endometriosis. 9 patients (2.9%) received neoadjuvant chemotherapy, 248 (80.5%) received postoperative chemotherapy, and among them, 238 (96%) received taxane-platinum chemotherapy. 275 patients (89.3%) achieved optimal debulking. 112 patients (37%) had recurrence, 182 (59.1%) was disease-free, and 12 (3.9%) lost follow up. Median value of CA-125 was 72.34 U/ml (range, 1.9-8930), 45.7 in stage I, 98.9 in stage II, 192.1 in stage III, and 634.8 in stage IV. 1-year, and 3-year rate of disease-free survival (DFS) was 70%, and 63%, respectively. 1-yr DFS rate was 90% in stage Ia and Ib, 88% in stage Ic and II, and 60% in stage III and IV. According to the same stage grouping, 3-year DFS rate was 82%, 70%, and 40%, respectively. Overall survival (OS) rate at 1 year was 97%, 99%, and 90%, and 97%, 96%, and 88% at 3 year. Multivariate analysis revealed optimal debulking (HR 6.62, p < 0.001) as a significant prognostic factor for DFS. Among the 94 patients with early stage (Ia and Ib), 17 patients (18.1%) received adjuvant chemotherapy, and there was no significant difference in DFS according to adjuvant chemotherapy (log rank p = 0.57). Conclusions: In patients with clear cell ovarian cancer, optimal debulking surgery was associated with improved DFS. And the role of adjuvant chemotherapy in early stage clear cell ovarian cancer is elusive and needs further study.

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“…A meta-analysis of evidence from 10 cohort studies also concluded that endometriosis is not a prognostic factor for the survival of OCCC patients [ 34 ]. A study conducted in Korea found that only in FIGO stage I patients was endometriosis an independent prognostic factor [ 19 ]. However, studies conducted in China found no prognostic role of endometriosis in OCCC patients [ 2 ], even when the tumor was confined to FIGO stage I [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…The sample size in these studies was limited and the last study spanned over a period of 27 years, during which time considerable changes in adjuvant therapies took place. The other studies also did not reach a consensus about the prognostic role of endometriosis [ 2 , 18 , 19 ]. The purpose of the present study was to investigate whether concomitant endometriosis affects the survival of patients with pure OCCC and to identify other prognostic factors in these patients.…”

Section: Introductionmentioning

confidence: 99%

Endometriosis does not confer improved prognosis in ovarian clear cell carcinoma: a retrospective study at a single institute

et al. 2018

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BackgroundConsidered as the precursor lesion of a subset of ovarian clear cell carcinoma (OCCC), the prognostic role of endometriosis in OCCC patients remains controversial. This study aimed to investigate the prognostic role of coexisting endometriosis in the survival of patients with OCCC, and also sought to identify other prognostic factors.ResultsA total of 125 patients were diagnosed with OCCC during the study period. Of these, 55 (44.0%) patients had coexisting endometriosis. Patients with endometriosis were younger (p = 0.030), had smaller tumor diameter (p = 0.005) and lower preoperative CA125 levels (p = 0.005). More patients with endometriosis had International Federation of Gynecology and Obstetrics (FIGO) stage I disease (83.6% vs. 51.4%, p = 0.000) and exhibited sensitivity to platinum-based regimen (89.6% vs. 66.7%, p = 0.003). Univariate and multivariate analysis revealed that coexisting endometriosis was not a predictor of 5-year overall survival (OS) or progression-free survival (PFS) of OCCC patients. For OS, chemosensitivity was the only useful prognostic factor (Hazards ratio (HR) 109.33, 95% Confidence Interval (CI) 23.46–511.51; p = 0.000). For PFS, the useful prognostic factors were ascites (HR 2.78, 95% CI 1.21–6.47; p = 0.016), FIGO stage (HR 1.61, 95% CI 1.04–2.49; p = 0.033), and chemosensitivity (HR 101.60, 95% CI 29.45–350.49; p = 0.000). Moreover, higher FIGO stage was the only risk factor for resistance to platinum-based chemotherapy (Exp (B) = 0.292, 95% CI 0.123–0.693; p = 0.005).ConclusionsIn this study, coexisting endometriosis was not a prognostic factor for the survival of OCCC patients. The most important predictor of both 5-year OS and PFS was chemosensitivity to platinum-based regimen, which decreased significantly with increase in FIGO stage.

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Significance of Ovarian Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma

Cited by 43 publications

References 15 publications

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea

Clinical characteristics of clear cell ovarian cancer: A retrospective multicenter experience of 308 patients in South Korea.

Endometriosis does not confer improved prognosis in ovarian clear cell carcinoma: a retrospective study at a single institute

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