An evaluation of progression free survival and overall survival of ovarian cancer patients with clear cell carcinoma versus serous carcinoma treated with platinum therapy: An NRG Oncology/Gynecologic Oncology Group experience

Abstract

Purpose We examined disparities in prognosis between patients with ovarian clear cell carcinoma (OCCC) and serous epithelial ovarian cancer (SOC). Methods We reviewed data from FIGO stage I–IV epithelial ovarian cancer patients who participated in 12 prospective randomized GOG protocols. Proportional hazards models were used to compare progression-free survival (PFS) and overall survival (OS) by cell type (clear cell versus serous). Results There were 10,803 patients enrolled, 9,531 were eligible, evaluable and treated with platinum, of whom 544 (6%) had OCCC, 7,054 (74%) had SOC, and 1,933 (20%) had other histologies and are not included further. In early stage (I–II) patients, PFS was significantly better in OCCC than in SOC patients. For late stage (III, IV) patients, OCCC had worse PFS and OS compared to SOC, OS HR= 1.66 (1.43, 1.91; p<0.001. After adjusting for age and stratifying by protocol and treatment arm, stage, performance status, and race, OCCC had a significantly decreased OS, HR= 1.53 (1.33, 1.76; p<0.001). In early stage cases, there was a significantly decreased treatment effect on PFS for consolidative therapy with weekly Paclitaxel versus observation in OCCC compared to SOC (p=0.048). Conclusions This is one of the largest analyses to date of OCCC treated on multiple cooperative group trials. OCCC histology is more common than SOC in early stage disease. When adjusted for prognostic factors, in early stage patients, PFS was better for OCCC than for SOC; however, in late-stage patients, OCCC was significantly associated with decreased OS. Finally, treatment effect was influenced by histology.

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea

“…However, it has significant poorer prognosis in advanced stage. Progression-free survival rate and survival rate in early-stage (I, II) OCCC at 5-year were 75% and 80%, respectively, compared to 63% and 78% in serous carcinoma [22]. In the present study, relapse-free survival rate and OS rate at 5-year for stage I and II were 68% and 91%, respectively, showing good prognosis of early-stage OCCC.…”

Clinical characteristics of clear cell ovarian cancer: A retrospective multicenter experience of 308 patients in South Korea.

“…However it has significant poorer prognosis in advanced stage. Progression-free survival rate and survival rate in early stage (I, II) OCCC at 5-year were 75% and 80%, respectively, compared to 63% and 78% in serous carcinoma [22]. In the present study, relapsefree survival rate and overall survival rate at 5-year for stage I and II were 68% and 91%, respectively, showing good prognosis of early stage OCCC.…”

“…Oliver et al [22] reported that OCCC in early stage has better prognosis than serous carcinoma. However it has significant poorer prognosis in advanced stage.…”

Ovarian Cancer Genetics: Subtypes and Risk Factors

“…Clinically, CCCs are typically diagnosed at an early stage; however, they are less responsive to front-line platinum-based chemotherapy, especially at later FIGO stages. When compared to matched serous disease, early stage CCC (I-II) had a better overall survival than serous, but late stage CCC (III-IV) had a worse prognosis than both serous [138] and endometrioid adenocarcinoma [137]. Interestingly, some evidence suggests that drug response can be correlated to CD44-10v isoform expression [139].…”