Advanced stage clear-cell epithelial ovarian cancer: The Hellenic cooperative oncology group experience

Pectasides, Dimitrios; Fountzilas, George; Aravantinos, G.; Kalofonos, C.; Efstathiou, Helen; Farmakis, Dimitrios; Skarlos, Dimosthenes; Pavlidis, N.; Economopoulos, Theofanis; Dimopoulos, Meletios Α.

doi:10.1016/j.ygyno.2005.12.038

Cited by 133 publications

(105 citation statements)

References 36 publications

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“…Finally, our findings regarding prognosis are in line with other studies, showing that performance status and residual tumor volume are consistently independent predictors of prognosis. [7][8][9] Previous data on the prognostic significance of histologic subtypes were only partially confirmed. Whereas mucinous histology was associated with significantly worse survival, clear cell carcinomas were not.…”

Section: Discussionmentioning

confidence: 99%

“…Most series showing an association of clear cell type with adverse prognosis have included a sizeable proportion of patients who did not receive paclitaxel. 9,10 The introduction of this agent has changed the prognosis in advanced ovarian cancer, and may have had an impact on this particular histological subtype. Indeed, in a small series of 31 patients, a significantly higher risk ratio and longer OS were observed for patients with clear cell carcinomas who received paclitaxel.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, clear cell and mucinous carcinomas have been identified in previous studies as adverse prognostic features. [7][8][9] Both histological subtypes are rare, comprising <10% of epithelial ovarian cancers. 10 It has been observed that both types have a poor response to chemotherapy, contrasting with that of serous histology, resulting in statistically lower 5-year survival rates.…”

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confidence: 99%

“…10 It has been observed that both types have a poor response to chemotherapy, contrasting with that of serous histology, resulting in statistically lower 5-year survival rates. 9,11 Nevertheless, previous analyses suffer from limitations. The most important are the small number of patients included (as expected because of the rarity of these types) and the heterogeneity of chemotherapy used, because many studies have not included patients treated with the current standard platinum/paclitaxel.…”

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confidence: 99%

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Mucinous but not clear cell histology is associated with inferior survival in patients with advanced stage ovarian carcinoma treated with platinum‐paclitaxel chemotherapy

Bamias

Ψαλτοπούλου

Sotiropoulou

et al. 2010

Cancer

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BACKGROUND: Mucinous and clear cell histology have been associated with adverse prognosis in ovarian carcinomas. The authors compared the outcome of these subtypes with that of serous tumors in patients who were treated with combination paclitaxel/platinum at their center. METHODS: Four hundred twenty patients with histologically confirmed, serous (n ¼ 367), mucinous (n ¼ 24), or clear cell (n ¼ 29) ovarian carcinomas, International Federation of Gynecology and Obstetrics stage III or IV disease, and who were treated with paclitaxel/platinum after cytoreductive surgery were included in this analysis. RESULTS: The median overall survival for each histological subtype was 47.7 months (95% confidence interval [CI], 37.7-57.7 months) for serous, 15.4 months (95% CI, 4.2-26.6 months) for mucinous, and 36.6 months (95% CI, 22.7-50.5 months) for clear cell carcinomas. Cox regression analysis showed that mucinous histology was an independent predictor of poor prognosis compared with serous tumors (hazard ratio, 0.360; 95% CI, 0.215-0.603; P ¼ .001). In contrast, such a difference between clear cell and serous carcinomas was not found (P ¼ .337). Median survival of patients with mucinous tumors and residual disease >2 cm was poor, averaging 7.1 months (95% CI, 4.6-9.6 months). CONCLUSIONS: Mucinous but not clear cell histology is associated with significantly worse prognosis in advanced ovarian cancer treated with combination platinum/paclitaxel. Different therapeutic strategies should be studied in this entity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Mucinous but not clear cell histology is associated with inferior survival in patients with advanced stage ovarian carcinoma treated with platinum‐paclitaxel chemotherapy

Bamias

Ψαλτοπούλου

Sotiropoulou

et al. 2010

Cancer

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“…OCCC has clinical characteristics and pathologic significance based on molecular features that are distinct from high-grade serous carcinoma of the ovary (6). Unfortunately, some studies reported that OCCC may be relatively resistant to standard platinum-based chemotherapy (7)(8)(9)(10)(11). It is necessary to improve our understanding of pathobiologic characteristics of OCCC in order to develop new therapeutic strategies and administer current treatment effectively.…”

Section: Introductionmentioning

confidence: 99%

Hypoxia promotes glycogen synthesis and accumulation in human ovarian clear cell carcinoma

et al. 2012

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Abstract. Ovarian clear cell carcinoma (OCCC) has several significant characteristics based on molecular features that are distinct from those of ovarian high-grade serous carcinoma. Cellular glycogen accumulation is the most conspicuous feature of OCCC and in the present study its metabolic mechanism was investigated. The amount of glycogen in cells cultured under hypoxia increased significantly and approximately doubled after 48 h (P<0.01) compared to that under normoxic conditions. Periodic acid-Schiff positive staining also demonstrated intracellular glycogen storage. Western blot analysis revealed that HIF1α, which was overexpressed and stabilized under hypoxic conditions, led to an increase in the levels of cellular glycogen synthase 1, muscle type (GYS1), and conversely to a decrease in inactive phosphorylated GYS1 at serine (Ser) 641. Additional increases were observed in both protein phosphatase 1, which dephosphorylates and thereby induces GYS1 enzyme activity, and glycogen synthase kinase 3 beta (GSK3β) phosphorylated at Ser9, which is inactive on phosphorylation of GYS1 and subsequently induces its enzyme activity. By contrast, the level of PYGM-b decreased. These results indicated that the glycogen accumulation under a hypoxic environment resulted in the promotion of glycogen synthesis, but did not lead to inhibition of glycogen degradation and/or consumption. Under hypoxic conditions, HAC2 cells showed activation of the PI3K/AKT pathway caused by a mutation in exon 20 of PIK3CA, encoding the catalytic subunit p110α of PI3K. The resulting activation of AKT (phosphoSer473) also plays a role as a central enhancer in glycogen synthesis through suppression of GSK3β via phosphorylation at Ser9. Hypoxia decreased the cytocidal activity of cisplatin and doxorubicin to various degrees. In conclusion, the hypoxic conditions together with HIF1 expression and stabilization increased the intracellular glycogen contents and resistance to the anticancer drugs.

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Cauda equina syndrome in an ovarian malignant‐mixed müllerian tumor with leptomeningeal spread

Bernstock

Ostby

Fox

et al. 2019

Clinical Case Reports

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Advanced stage clear-cell epithelial ovarian cancer: The Hellenic cooperative oncology group experience

Cited by 133 publications

References 36 publications

Mucinous but not clear cell histology is associated with inferior survival in patients with advanced stage ovarian carcinoma treated with platinum‐paclitaxel chemotherapy

Mucinous but not clear cell histology is associated with inferior survival in patients with advanced stage ovarian carcinoma treated with platinum‐paclitaxel chemotherapy

Hypoxia promotes glycogen synthesis and accumulation in human ovarian clear cell carcinoma

Cauda equina syndrome in an ovarian malignant‐mixed müllerian tumor with leptomeningeal spread

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