Clear cell carcinoma of the ovary

Abstract

This retrospective analysis aimed to clarify the clinical and pathologic features of ovarian clear cell carcinoma (OCCC), and to determine the factors predictive of survival.Data waereextracted from OCCC patients who underwent primary surgery followed by adjuvant chemotherapy in Obstetrics & Gynecology Hospital of Fudan University between January2007 and December 2014. Kaplan-Meier survival estimates and Cox proportional hazards model were used for survival analyses.Of 130 patients (mean age = 56.2 years), 66.2% had stage I disease when the 5-year overall survival and 5-year disease-free survival were 89.2% and 88.1%, respectively. Patients frequently presented with large pelvic mass (>10 cm) and mild-to-moderate elevation of serological CA125 (≤200U/ mL). 60.7% of the cases at stage III/IV exhibited resistance to platinum-based chemotherapy; 37.69% of the tumors arose from endometriosis. On multivariate analysis, stage and chemoresistance were independent prognostic factors predictive for poorer survival. Survival at stage IC1 (surgical rupture) was comparable to that at stage IA (capsule intact), whereas survival at stage IC2/IC3 (rupture before surgery) was significantly worse than that at stage IA.OCCC shows distinct features compared to other epithelial ovarian cancers. FIGO stage and response to chemotherapy affect prognosis independently. Arising from endometriosis is not associated with better survival. Preoperative rupture rather than intraoperative rupture confers an adverse prognosis in otherwise stage IA disease.

Effect of Chemotherapy, Laparoscopy, and Cytology on Stage IC Ovarian Clear Cell Carcinoma: A Long-Term, Single-Center Study

“…Washing cytology obtained during surgery played a critical role in the outcome of OCCC based on the literature [12]. Because of the long study period, much of the data were missing, and only limited results for washing cytology were obtained.…”

Clear-Cell Carcinoma of the Ovary with Bilateral Breast Metastases

“…However, presentation with advanced disease stage or recurrence has a worse prognosis than the more common subtypes serous and endometrioid carcinoma [16]. This is due to the lack of chemosensitivity to platinum-based chemotherapy [17]. The presence of specific molecular characteristics such as PIK3CA (phosphatidylinositol 3-kinase p110 α catalytic subunit gene) and ARID1a (AT-rich interactive domain-containing protein 1A) mutations, and MET gene amplification have been proposed to be associated with chemoresistance warranting dual inhibitor targeting in advanced stages [18].…”

Napsin-A Expression, a Reliable Immunohistochemical Marker for Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas

“…In ovary, the biology and clinical behavior of ovarian clear cell carcinoma (OCCC) is different from other epithelial tumors. Unlike high grade papillary serous carcinomas (HGSC), OCCC affects younger women in association with endometriosis and is frequently diagnosed in early stages (3). When adjusted for stage, OCCC has the worst prognosis in comparison with other epithelial carcinomas (4,5).…”

“…When adjusted for stage, OCCC has the worst prognosis in comparison with other epithelial carcinomas (4,5). Efficacy of platinum-based chemotherapy regimens is between 20 and 50% for OCCC compared with 60 to 80% for HGSC (3). In endometrium, clear cell carcinomas involve older patients and are diagnosed in higher stage of disease with worse prognosis compared with endometrioid or type I carcinomas (2,6).…”