Mechanisms of chemoresistance and poor prognosis in ovarian clear cell carcinoma
- PMID: 18377417
- PMCID: PMC11158134
- DOI: 10.1111/j.1349-7006.2008.00747.x
Mechanisms of chemoresistance and poor prognosis in ovarian clear cell carcinoma
Abstract
Clear cell carcinoma (CCC) accounts for 4% to 12% of epithelial ovarian cancer in Western countries and, for some unknown reasons, it comprises more than 20% of such cancers in Japan. CCC shows unique clinical features such as a high incidence of stage I disease, a large pelvic mass, an increased incidence of vascular thromboembolic complications, and hypercalcemia. It is frequently associated with endometriosis. Compared to serous adenocarcinoma (SAC), CCC is relatively resistant to conventional platinum, or taxane-based chemotherapy which is associated with its poor prognosis. However, the mechanisms underlying CCC's resistance to chemotherapy have not been understood. Although several mechanisms involved in drug resistance exist in CCC, including decreased drug accumulation, increased drug detoxification, and an increased DNA repair activity; however, no particular chemoresistance system has been identified. On the other hand, an in vitro study revealed that low cell proliferation may cause the insensitivity of CCC to cisplatin. The Ki-67 labeling index in CCC tumors was significantly lower than SAC. The Ki-67 labeling index for responders was significantly higher than that for non-responders in both tumor types. A multivariable analysis revealed that Ki-67 labeling index and residual tumor size were independent prognostic factors in CCC. Therefore, lower proliferation of the tumor cells may contribute to their resistance to chemotherapy. However, further investigation into the molecular biology and genetics of CCC is warranted. This review discusses the current state of knowledge of the chemoresistance mechanism in CCC and novel treatment strategies for CCC.
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References
-
- Schiller W. Mesonephroma ovarii. Am J Cancer 1939; 35: 1–21.
-
- Scully RE. Recent progress in ovarian cancer. Hum Pathol 1970; 1: 73–98. - PubMed
-
- Serov SF, Scully RE, Sobin LH, eds. Histological Typing of Ovarian Tumours. (International Histological Classification No. 9). Geneva: World Health Organization, 1973; 17–54.
-
- Aure JC, Hoeg K, Kolstad P. Clinical and histologic studies of ovarian carcinoma. Long‐term follow‐up of 990 cases. Obstet Gynecol 1971; 37: 1–9. - PubMed
-
- Kennedy AW, Biscotti CV, Hart WR, Webster KD. Ovarian clear cell adenocarcinoma. Gynecol Oncol 1989; 32: 342–9. - PubMed
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