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. 2015 Nov;139(2):236-41.
doi: 10.1016/j.ygyno.2015.09.016. Epub 2015 Sep 25.

Ovarian clear cell carcinoma, outcomes by stage: the MSK experience

Catherine A Shu  1 , Qin Zhou  2 , Anjali R Jotwani  1 , Alexia Iasonos  2 , Mario M Leitao Jr  3 , Jason A Konner  4 , Carol A Aghajanian  5
Affiliations

Ovarian clear cell carcinoma, outcomes by stage: the MSK experience

Catherine A Shu et al. Gynecol Oncol. 2015 Nov.

Abstract

Objective: Ovarian clear cell carcinomas (OCCCs) are rare, and uncertainty exists as to the optimal treatment paradigm and validity of the FIGO staging system, especially in early-stage disease.

Methods: We performed a retrospective cohort study of all OCCC patients diagnosed and treated at Memorial Sloan Kettering Cancer Center between January 1996 and December 2013. Progression-free survival (PFS) and overall survival (OS) were calculated by stage and race, and comparisons were made using the log-rank test. Statistical significance was set at p<0.05. Type and duration of treatment were also recorded.

Results: There were 177 evaluable patients. The majority of patients were stage I at diagnosis (110/177, 62.2%). Of these, 60/110 (54.6%) were stage IA, 31/110 (28.2%) were stage IC on the basis of rupture-only, and 19/110 (17.3%) were stage IC on the basis of surface involvement and/or positive cytology of ascites or washings. Patients with stage IA and IC based on rupture-only had similar PFS/OS outcomes. Patients with stage IC based on surface involvement and/or positive cytology had a statistically significant decrement in PFS/OS. Stage was an important indicator of PFS/OS, while race was not.

Conclusions: OCCC often presents in early stage. Women with stage IA OCCC have excellent prognosis, and future studies should explore whether they benefit from adjuvant chemotherapy. Women with IC OCCC need further staging clarification, as surgical rupture alone affords better prognosis than surface involvement and/or positive cytology. Women with advanced OCCC have poor survival and are often chemotherapy resistant/refractory. New treatment paradigms are needed.

Keywords: Clear cell; FIGO staging; Ovarian cancer; Overall survival; Progression-free survival.

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Conflict of interest statement

Conflict of Interest Statement

The authors do not have any conflicts to disclose.

Figures

Figure 1
Figure 1
Kaplan Meier Survival Analysis.
Figure 2
Figure 2
Kaplan Meier Survival Analysis stratified by stage.
Figure 3
Figure 3
Kaplan Meier Survival Analysis stratified by race.
Figure 4
Figure 4
PFS and OS Stratified by Stage I Breakdown. Figure 4A. Kaplan Meier Survival Analysis (PFS) stratified by stage I breakdown. Figure 4B. Kaplan Meier Survival Analysis (OS) stratified by stage I breakdown.
Figure 4
Figure 4
PFS and OS Stratified by Stage I Breakdown. Figure 4A. Kaplan Meier Survival Analysis (PFS) stratified by stage I breakdown. Figure 4B. Kaplan Meier Survival Analysis (OS) stratified by stage I breakdown.
See this image and copyright information in PMC

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