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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 3/2019

01-09-2019 | Fertility | Gynecologic Oncology

Long-term oncologic outcome and its prognostic indicators in reproductive-age women with ovarian clear-cell carcinoma

Authors: Hiroaki Kajiyama, Shiro Suzuki, Nobuhisa Yoshikawa, Kaoru Niimi, Michiyasu Kawai, Kiyosumi Shibata, Fumitaka Kikkawa

Published in: Archives of Gynecology and Obstetrics | Issue 3/2019

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Abstract

Background

Clear-cell carcinoma (CCC) in reproductive-age women is likely to become an increasingly critical issue regarding possibilities of infertility, hormonal dysfunction, and mortality. The aim of this study was to examine the long-term oncologic outcome and its prognostic indicators based on a multicentric cohort of young patients with CCC.

Patients and methods

During the period of 1990–2015, a total of 164 patients aged 45-year-old or younger were enrolled in the study. Clinicopathologic data of these young patients with CCC collected under a centralized pathological review system were subjected to uni- and multivariable analyses to evaluate overall survival (OS).

Results

The median follow-up was 73.8 months (range 5.2–244.2) in the surviving patients. Among these patients, 104 (63.4%) had FIGO I disease, and 22 (13.4%), 31 (18.9%), and 7 (4.3%) had II, III, and IV disease, respectively. The 5-year OS rate was 74.5%. On stratification by the FIGO stage, the 5-year OS rates were as follows: stage I (90.2%), stage II (57.9%), and stage III/IV (39.3%), respectively (P < 0.0001). Confining analysis to stage I patients, there was no difference in OS between those who underwent fertility-sparing surgery and those who received radical surgery (P = 0.1593). In relapsed patients, the median survival after recurrence was 11.6 months. In multivariable analysis of stage I patients, the capsule status was an independent prognostic indicator of OS {IC2/IC3 vs. IA/IC1: HR 4.293 (95% CI 1.140–16.422), P = 0.0318}.

Conclusion

CCC patients staged greater than IC2/IC3 show a markedly increased risk of mortality. Thus, it is important to diagnose patients staged under IC2/IC3.
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Metadata
Title
Long-term oncologic outcome and its prognostic indicators in reproductive-age women with ovarian clear-cell carcinoma
Authors
Hiroaki Kajiyama
Shiro Suzuki
Nobuhisa Yoshikawa
Kaoru Niimi
Michiyasu Kawai
Kiyosumi Shibata
Fumitaka Kikkawa
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 3/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05203-y

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