Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: A 10-Year Retrospective Study

Zhu, Chenchen; Zhu, Jing; Qian, Lili; Liu, Hanyuan; Zhang, Shen; Wu, Dexiang; Zhang, Weidong; Xiao, Weihua; Ying, Zhe

doi:10.21203/rs.3.rs-81462/v1

Cited by 3 publications

(5 citation statements)

References 32 publications

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“…The patients had a mean age at the time of diagnosis of 51 years. This was consistent with the results of a previous study in which the median age in patients with CCC was 49-51 years old, which was significantly younger than that of patients with serous carcinoma of the ovary (55 vs. 64 years) [13][14][15]. The preoperative level of CA 125 was less than 35 IU/mL (normal) in 23% of all patients in this study.…”

Section: Discussionsupporting

confidence: 92%

Incidence and predictive factors for recurrent clear cell ovarian carcinoma: results from a single center in Thailand

Hemman

Rattanaburi

2022

Obstet Gynecol Sci

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We aimed to study the incidence and predictive factors of recurrent clear cell ovarian carcinoma (CCC) and evaluate the oncological outcomes after recurrence. MethodsThis was a retrospective study of 134 CCC cases diagnosed between 2005 and 2020.Clinicopathological data and oncological outcomes were extracted and evaluated. Patients with comalignancy, mixed pathological type, or incomplete data were excluded. Descriptive statistics, univariate and multivariable analyses, and Kaplan-Meier survival probability estimates were completed. A proportional hazards model was used to assess the association between the prognostic factors with progression-free survival (PFS), overall survival (OS), and post-recurrence survival. ResultsA total of 134 patients with CCC were enrolled. The incidence of recurrent CCC was 33.6% (45/134).The median PFS was 12.8 months (95% confidence interval [CI], 9.66-18.9) in the recurrence group and 3.3 months (95% CI, 1.15-4.4) in the refractory group. Residual tumor from surgical outcome, ascites cytology, and lymphovascular space invasion (LVSI) were independent prognostic factors for PFS. The significant variables were residual tumor (sub-optimal surgery vs. optimal surgery) (hazard

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Section: Discussionsupporting

confidence: 92%

Incidence and predictive factors for recurrent clear cell ovarian carcinoma: results from a single center in Thailand

Hemman

Rattanaburi

2022

Obstet Gynecol Sci

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“…Ovarian clear cell carcinoma (OCCC) is an uncommon malignant type of the 5 subtypes of ovarian cancers, with specific genetic and molecular features. [ 1 ] It is the second leading cause of death in ovarian cancers. However, it is relatively rare, accounting for 5% to 25% of all ovarian cancers.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It accounts for 5% to 10% of all epithelial ovarian cancers in North America and 12% in Western countries; however, it seems to be highest in East Asia, with an estimated 25% to 30% and 10.3% to 11.6% of all epithelial ovarian cancers in Japan and Korea, respectively, [3,4] particularly among young people (median age, 50.2-55.7 years). [1] In contrast to other ovarian carcinomas, most individuals with OCCC are often diagnosed at an early age and an early stage of the disease, with mild to moderate elevation of serum CA125 levels. [5] More than 50% of OCCC cases are associated Patient informed consent was obtained.…”

Section: Introductionmentioning

confidence: 99%

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Clinical analysis and literature review of a case of ovarian clear cell carcinoma with PIK3CA gene mutation: A case report

Farah

Jia

2022

Medicine

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Rationale: Ovarian clear cell carcinoma (OCCC) is an uncommon malignant form of 5 subtypes of ovarian cancer, accounting for approximately 5% to 25% of all ovarian cancers. OCCC is usually diagnosed at a young age and an early stage. More than 50% of patients are associated with endometriosis. It shows less sensitivity to platinum-based chemotherapies, high recurrence, and poor prognosis, especially late. However, platinum-based chemotherapies remain the first-line treatment. Meanwhile, new treatment modalities have been explored, including immune checkpoint inhibitors and PI3K-AKT-mTOR pathway inhibitors. Patient concern: A 48-year-old Chinese woman, Gravida2 Para1, complained of irregular and painful vaginal bleeding for 4 months. Diagnosis: The patient was diagnosed with stage IC ovarian clear cell carcinoma that presented with a mutation of the phosphatidylinositol 4,5-bisphosphate 3-kinase alpha subunit (PIK3CA) gene. Intervention: We performed an early diagnosis and complete surgical resection of the tumor with platinum-based chemotherapy. Outcome: This patient with mutation of the PIK3CA gene was sensitive to platinum-based chemotherapy, showed a significant downwards trend in tumor markers, and was in good health within the year of follow-up. Lessons: This study described an OCCC case that presented with a PIK3CA mutation and was successfully managed with careful and complete resection of the tumor. This patient with mutation of the PIK3CA gene was sensitive to platinum-based chemotherapy, showed a significant downwards trend in tumor markers, and did not have recurrence after a year of follow-up, indicating a reasonably good prognosis. Therefore, surgery plus platinum drug chemotherapy is still the best strategy for OCCC treatment. In addition, it is recommended for such patients to undergo genetic testing as much as possible to predict the clinical treatment effect.

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“…The treatment strategies for OCCC include surgery and platinum-based chemotherapy, while the chemo-resistant nature of the disease means the effect of these therapies is unsatisfactory, especially for patients with stage III or IV disease (3). A previous study has revealed that advanced OCCC is associated with a poor prognosis that the 3-year overall survival (OS) rate is less than 45% (4).…”

Section: Introductionmentioning

confidence: 99%

Pathologic complete response to immune checkpoint inhibitor in a stage IIIB ovarian clear cell carcinoma patient with POLE mutation resistant to platinum-based chemotherapy: a case report

Li¹,

Zhang²,

Du³

et al. 2022

Gland Surg

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Background: Ovarian clear cell carcinoma (OCCC) is a subtype of ovarian cancer with unique features at histological and molecular levels. The prevalence of OCCC is higher in east Asia than in Western countries.As cases are usually chemo-resistant, treatment effects of platinum-based chemotherapy are not satisfactory, especially for patients with stage III or IV disease. Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of patients with advanced-stage cancers. However, whether advanced OCCC patients benefit from ICIs remains elusive.Case Presentation: Herein, we report a Chinese patient with stage IIIB inoperable OCCC who was resistant to platinum-based chemotherapy and anlotinib. Next-generation sequencing (NGS) revealed a pathogenic polymerase epsilon (POLE) P286R mutation and a high level of tumor mutation burden (TMB) in tissue and plasma samples. The ICI sintilimab was then used with bevacizumab as third-line treatment.Tumor reduction was observed, and the patient underwent surgical resection which indicated a pathologic complete response (pCR). Maintenance therapy with sintilimab and bevacizumab was applied, and the patient has achieved overall survival (OS) of 35 months since the diagnosis. They have also achieved a progressionfree survival (PFS) of 29 months since commencing ICI treatment and have been disease-free for 24 months after surgical resection. Conclusions:The treatment effect of ICI in POLE-mutant OCCC patients has been rarely reported.The treatment benefits observed in the stage IIIB OCCC patient who was resistant to platinumbased chemotherapy may be associated with the presence of POLE mutation and a high level of TMB.Comprehensive genomic profiling could contribute to appropriate treatment decisions for OCCC.

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Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: A 10-Year Retrospective Study

Cited by 3 publications

References 32 publications

Incidence and predictive factors for recurrent clear cell ovarian carcinoma: results from a single center in Thailand

Incidence and predictive factors for recurrent clear cell ovarian carcinoma: results from a single center in Thailand

Clinical analysis and literature review of a case of ovarian clear cell carcinoma with PIK3CA gene mutation: A case report

Pathologic complete response to immune checkpoint inhibitor in a stage IIIB ovarian clear cell carcinoma patient with POLE mutation resistant to platinum-based chemotherapy: a case report

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