Surgical and Medical Treatment of Clear Cell Ovarian Cancer

Magazzino, Francescapaola; Katsaros, Dionyssios; Ottaiano, Alessandro; Gadducci, Angiolo; Pisano, Carmela; Sorio, Roberto; Rabaiotti, Emanuela; Scambia, Giovanni; Cormio, Gennaro; Scarampi, Luca; Greggi, Stefano; Savarese, Antonella; Marinaccio, Marco; Scollo, Paolo; Pignata, Sandro

doi:10.1097/igc.0b013e318218f270

Cited by 44 publications

(27 citation statements)

References 25 publications

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“…On a similar note, the role of lymphadenectomy from a therapeutic perspective is unclear. It is acknowledged that the presence of lymph node metastases is an independent prognostic factor however it is not associated with OS on multivariate analysis [7879808182]. Importantly, women undergoing fertility sparing surgery in OCCC did not show poorer survival than their non-OCCC counterparts [8384858687].…”

Section: Clear Cell Carcinomamentioning

confidence: 99%

Update on rare epithelial ovarian cancers: based on the Rare Ovarian Tumors Young Investigator Conference

et al. 2017

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There has been significant progress in the understanding of the pathology and molecular biology of rare ovarian cancers, which has helped both diagnosis and treatment. This paper provides an update on recent advances in the knowledge and treatment of rare ovarian cancers and identifies gaps that need to be addressed by further clinical research. The topics covered include: low-grade serous, mucinous, and clear cell carcinomas of the ovary. Given the molecular heterogeneity and the histopathological rarity of these ovarian cancers, the importance of designing adequately powered trials or finding statistically innovative ways to approach the treatment of these rare tumors has been emphasized. This paper is based on the Rare Ovarian Tumors Conference for Young Investigators which was presented in Tokyo 2015 prior to the 5th Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup (GCIG).

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Section: Clear Cell Carcinomamentioning

confidence: 99%

Update on rare epithelial ovarian cancers: based on the Rare Ovarian Tumors Young Investigator Conference

et al. 2017

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“…However, the role of lymphadenectomy remains unclear based on the therapeutic aspect. Several authors reported that lymph node metastasis is independent prognostic factor for CCC [7,8,15]. Magazzino et al analyzed 240 CCC retrospectively and reported as followed [15]: (1) Of 240 cases, 47.9% had lymphadenectomy and most of cases received platinum based chemotherapy after primary surgery.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Several authors reported that lymph node metastasis is independent prognostic factor for CCC [7,8,15]. Magazzino et al analyzed 240 CCC retrospectively and reported as followed [15]: (1) Of 240 cases, 47.9% had lymphadenectomy and most of cases received platinum based chemotherapy after primary surgery. (2) The cases who received lymphadenectomy had longer progression-free survival (PFS) than the cases who had no lymphadenectomy in stage I/II, III/IV and all stage (p = 0.0258, p = 0.00337, p = 0.0001).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Clear cell carcinoma of the ovary: Is there a role of histology-specific treatment?

Takano

Tsuda

Sugiyama

2012

J Exp Clin Cancer Res

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Several clinical trials to establish standard treatment modality for ovarian cancers included a high abundance of patients with serous histologic tumors, which were quite sensitive to platinum-based chemotherapy. On the other hand, ovarian tumor with rare histologic subtypes such as clear cell or mucinous tumors have been recognized to show chemo-resistant phenotype, leading to poorer prognosis. Especially, clear cell carcinoma of the ovary (CCC) is a distinctive tumor, deriving from endometriosis or clear cell adenofibroma, and response rate to platinum-based therapy is extremely low. It was implied that complete surgical staging enabled us to distinguish a high risk group of recurrence in CCC patients whose disease was confined to the ovary (pT1M0); however, complete surgical staging procedures could not lead to improved survival. Moreover, the status of peritoneal cytology was recognized as an independent prognostic factor in early-staged CCC patients, even after complete surgical staging. In advanced cases with CCC, the patients with no residual tumor had significantly better survival than those with the tumor less than 1 cm or those with tumor diameter more than 1 cm. Therefore, the importance of achieving no macroscopic residual disease at primary surgery is so important compared with other histologic subtypes. On the other hand, many studies have shown that conventional platinum-based chemotherapy regimens yielded a poorer prognosis in patients with CCC than in patients with serous subtypes. The response rate by paclitaxel plus carboplatin (TC) was slightly higher, ranging from 22% to 56%, which was not satisfactory enough. Another regimen for CCC tumors is now being explored: irinotecan plus cisplatin, and molecular targeting agents. In this review article, we discuss the surgical issues for early-staged and advanced CCC including possibility of fertility-sparing surgery, and the chemotherapy for CCC disease.

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“…Out of 240 patients with ovarian CCC [31], we identified 72 cases with recurrent disease (28% stage I-II and 72% stage III-IV at diagnosis).…”

Section: Methodsmentioning

confidence: 99%

Second-Line Chemotherapy in Recurrent Clear Cell Ovarian Cancer: Results from the Multicenter Italian Trials in Ovarian Cancer (MITO-9)

et al. 2014

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Background and Aims: Ovarian clear cell carcinoma (CCC) has a poorer prognosis than other subtypes of ovarian cancer. In this study, we evaluated the responsiveness to second-line chemotherapy in recurrent ovarian CCC. Methods: The MITO-9 project investigated a cohort of patients observed between 1991 and 2007 in 20 centers. We identified 72 out of 240 patients with recurrent disease (28% stage I-II and 72% stage III-IV at diagnosis). Results: In 56% of patients, the clear cell histology was pure. Twenty-five patients were platinum-resistant, 18 were platinum-sensitive with a platinum-free interval (PFI) of 6-12 months, and 29 had a PFI >12 months. Upon recurrence, 47% of patients were treated with platinum chemotherapy according to the PFI. The overall response rate (RR) to platinum was 80%, with 55, 100, and 80% RR in patients with PFI of 6-12, >12, and >24 months. The RR to nonplatinum agents in resistant patients was 33%. Among the nonplatinum agents used in primary and secondary resistant cases, gemcitabine, administered in 12 cases, had a higher activity (RR = 66%) compared to topotecan or liposomal doxorubicin (n = 31; RR = 33 and 10%, respectively). Conclusions: This study showed that the treatment of recurrent ovarian CCC should be based on the PFI as in the other subtypes. Data in platinum-resistant patients suggest gemcitabine as the drug with the highest activity. We recommend that gemcitabine be studied prospectively in a phase 2 trial.

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Surgical and Medical Treatment of Clear Cell Ovarian Cancer

Abstract: This analysis suggests that lymphadenectomy has a strong prognostic role for clear cell ovarian cancer influencing disease-free survival and overall survival. The addition of paclitaxel to platinum-based chemotherapy does not affect the outcome.

Cited by 44 publications

References 25 publications

Update on rare epithelial ovarian cancers: based on the Rare Ovarian Tumors Young Investigator Conference

Update on rare epithelial ovarian cancers: based on the Rare Ovarian Tumors Young Investigator Conference

Clear cell carcinoma of the ovary: Is there a role of histology-specific treatment?

Second-Line Chemotherapy in Recurrent Clear Cell Ovarian Cancer: Results from the Multicenter Italian Trials in Ovarian Cancer (MITO-9)

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