Background: Clear cell carcinoma (CCC) is a rare aggressive histologic subtype of endometrial cancer with a high relapse rate. In the present study, we sought to evaluate the prognostic factors of disease relapse and overall survival. Methods: We conducted retrospective cohort studies that included endometrial CCC patients treated at our institution. Predictive variables of survival outcomes were evaluated considering factors that determine the survival of patients with endometrioid carcinoma. Results: Fifty-five patients with a median age of 68 years and a median follow-up period of 31 months were included in the present study. Recurrence-free and overall survival rates did not differ among patients with early-stage and advanced-stage disease (RFS HR 1.51 (95% CI 0.63, 3.61), OS HR 1.36 (0.56, 3.31)). Patients with upper abdominal metastases had significantly shorter progression-free and overall survival intervals (log-rank < 0.001). The Gehan-Breslow-Wilcoxon analysis indicated worse survival rates for patients with advanced disease (p = 0.040); however, the log-rank test that gave equal weight to all time points did not reveal significant differences (log-rank = 0.576). Conclusion: Clear cell carcinoma is an aggressive histologic subtype of endometrial cancer that seems to be moderately affected by known predictors of survival rates in endometrioid carcinoma patients, except for the disease stage. Further research is needed to evaluate whether the molecular profiling of these patients may help predict survival outcomes.
2022-RA-1504-ESGO Figure 1 Results In total, 83 patients were included in this analysis. Two patients who received T-P as primary HT reached complete response (CR). Among patient who received P-only therapy (n=81), 35 (43.2%) achieved CR, while 46 (56.8%) did not. Of those with persistent disease, 31 (67.4%) underwent hysterectomy and others (n=15) were recommended T-P therapy. Except for five patients who did not complete medication, 10 patients completed T-P therapy at least 6 cycles with median observation period of 41.4 months. Among them, seven (70%) showed CR, and only three (30%) underwent hysterectomy for persistent disease.Conclusion T-P therapy should be considered as one of the treatment options for early-stage endometrial cancer patients who have previously failed P-only therapy. More studies are needed to predict the response to HT by investigating the molecular classification of endometrial cancer.
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