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Archives of Gynecology and Obstetrics

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01-10-2015 | Gynecologic Oncology

The clinical characteristics and outcomes of cases with pure ovarian clear cell, mixed type and high-grade serous adenocarcinoma

Authors: Umran Kucukgoz Gulec, Semra Paydas, Ahmet Baris Guzel, Mehmet Ali Vardar, Ghanim Khatib, Derya Gumurdulu

Published in: Archives of Gynecology and Obstetrics | Issue 4/2015

Abstract

Purpose

This study aimed to compare the clinical characteristics and outcomes of the cases with pure ovarian clear cell adenocarcinoma (OCCC), mixed type (clear plus serous or clear plus endometrioid or serous plus clear plus endometrioid) ovarian adenocarcinoma (MOC) and high-grade serous ovarian adenocarcinoma (HGSOC).

Methods

A retrospective comparison was conducted in 32 cases with pure OCCC, 23 cases with MOC and 28 cases with HGSOC followed between January 1999 and October 2011. Clinico-pathologic characteristics including histopathologic subtypes, age, stage, presence of ascites and/or peritoneal carcinomatosis, endometriosis and optimal cytoreduction, and also survival rates were compared in these three groups.

Results

The cases with pure OCCC were younger than the cases with MOC and HGSOC (p = 0.004). The median pre-operative CA-125 level was lower in the pure OCCC than in MOC and HGSOC (p = 0.006) (p = 0.001, p = <0.001, respectively). Bilaterality and peritoneal carcinomatosis were more frequently seen in the HGSOC group (p = 0.001, p < 0.001, respectively). The majority of the cases (65 %) had stage I or II disease in the pure OCCC group, but most of the cases in the HGSOC group had advanced stage disease (p < 0.001). Endometriosis was found in 16 cases (16/55, 29 %) in the OCCC group. No significant difference was detected with regard to the median survival rate among three groups (p = 0.517), while the stage of disease was found to be the only important factor for survival (p = 0.002).

Conclusion

Pure OCCC, MOC and HGSOC represent distinct clinical characteristics. Clinical characteristics of MOC are more similar to those of HGSOC.

del Carmen MG, Birrer M, Schorge JO (2012) Clear cell carcinoma of the ovary: a review of the literature. Gynecol Oncol 126(3):481–490CrossRefPubMed

Anglesio MS, Carey MS, Köbel M, Mackay H, Huntsman DG (2010) Vancouver Ovarian Clear Cell Symposium Speakers (2011) Clear cell carcinoma of the ovary: a report from the first Ovarian Clear Cell Symposium, June 24th, 2010. Gynecol Oncol 121(2):407–415CrossRef

Heidemann LN, Hartwell D, Heidemann CH, Jochumsen KM (2014) The relation between endometriosis and ovarian cancer–a review. Acta Obstet Gynecol Scand 93:20–31CrossRefPubMed

Gounaris I, Charnock-Jones DS, Brenton JD (2011) Ovarian clear cell carcinoma-bad endometriosis or bad endometrium? J Pathol 225(2):157–160CrossRefPubMed

Boyraz G, Selcuk I, Yazıcıoğlu A, Tuncer ZS (2013) Ovarian carcinoma associated with endometriosis. Eur J Obstet Gynecol Reprod Biol 170(1):211–213CrossRefPubMed

Wiegand KC, Shah SP, Al-Agha OM, Zhao Y, Tse K, Zeng T, Senz J, McConechy MK, Anglesio MS, Kalloger SE, Yang W, Heravi-Moussavi A, Giuliany R, Chow C, Fee J, Zayed A, Prentice L, Melnyk N, Turashvili G, Delaney AD, Madore J, Yip S, McPherson AW, Ha G, Bell L, Fereday S, Tam A, Galletta L, Tonin PN, Provencher D, Miller D, Jones SJ, Moore RA, Morin GB, Oloumi A, Boyd N, Aparicio SA, IeM Shih, Mes-Masson AM, Bowtell DD, Hirst M, Gilks B, Marra MA, Huntsman DG (2010) ARID1A mutations in endometriosis-associated ovarian carcinomas. N Engl J Med 363(16):1532–1543PubMedCentralCrossRefPubMed

Munksgaard PS, Blaakaer J (2012) The association between endometriosis and ovarian cancer: a review of histological, genetic and molecular alterations. Gynecol Oncol 124(1):164–169CrossRefPubMed

Despierre E, Yesilyurt BT, Lambrechts S, Johnson N, Verheijen R, van der Burg M, Casado A, Rustin G, Berns E, Leunen K, Amant F, Moerman P, Lambrechts D, Vergote I, EORTC GCG and EORTC GCG Translational Research Group (2014) Epithelial ovarian cancer: rationale for changing the one-fits-all standard treatment regimen to subtype-specific treatment. Int J Gynecol Cancer 24(3):468–477CrossRefPubMed

Vilming Elgaaen B, Olstad OK, Haug KB, Brusletto B, Sandvik L, Staff AC, Gautvik KM, Davidson B (2014) Global miRNA expression analysis of serous and clear cell ovarian carcinomas identifies differentially expressed miRNAs including miR-200c-3p as a prognostic marker. BMC Cancer 14:80PubMedCentralCrossRefPubMed

10.

Skirnisdottir I, Bjersand K, Akerud H, Seidal T (2013) Napsin A as a marker of clear cell ovarian carcinoma. BMC Cancer 13:524PubMedCentralCrossRefPubMed

11.

Wu RC, Ayhan A, Maeda D, Kim KR, Clarke BA, Shaw P, Chui MH, Rosen B, IeM Shih, Wang TL (2014) Frequent somatic mutations of the telomerase reverse transcriptase promoter in ovarian clear cell carcinoma but not in other major types of gynaecological malignancy. J Pathol 232(4):473–481PubMedCentralCrossRefPubMed

12.

Uekuri C, Shigetomi H, Ono S, Sasaki Y, Matsuura M, Kobayashi H (2013) Toward an understanding of the pathophysiology of clear cell carcinoma of the ovary (Review). Oncol Lett 6(5):1163–1173PubMedCentralPubMed

13.

Yamaguchi K, Huang Z, Matsumura N, Mandai M, Okamoto T, Baba T, Konishi I, Berchuck A, Murphy SK (2014) Epigenetic determinants of ovarian clear cell carcinoma biology. Int J Cancer 135(3):585–597PubMedCentralCrossRefPubMed

14.

Rauh-Hain JA, Winograd D, Growdon WB, Schorge JO, Goodman AK, Boruta DM, Berkowitz RS, Horowitz NS, Del Carmen MG (2012) Prognostic determinants in cases with uterine and ovarian clear carcinoma. Gynecol Oncol 125(2):376–380CrossRefPubMed

15.

Lee YY, Kim TJ, Kim MJ, Kim HJ, Song T, Kim MK, Choi CH, Lee JW, Bae DS, Kim BG (2011) Prognosis of ovarian clear cell carcinoma compared to other histological subtypes: a meta-analysis. Gynecol Oncol 122(3):541–547CrossRefPubMed

16.

Yoshino K, Enomoto T, Fujita M, Ueda Y, Kimura T, Kobayashi E, Tsutsui T, Kimura T (2013) Salvage chemotherapy for recurrent or persistent clear cell carcinoma of the ovary: a single-institution experience for a series of 20 cases. Int J Clin Oncol 18(1):148–153CrossRefPubMed

17.

Rauh-Hain JA, Davis M, Clemmer J, Clark RM, Growdon WB, Goodman AK, Boruta DM 2nd, Schorge JO, del Carmen MG (2013) Prognostic determinants in cases with uterine and ovarian clear cell carcinoma: a SEER analysis. Gynecol Oncol 131(2):404–409CrossRefPubMed

18.

Hirasawa T, Miyazawa M, Yasuda M, Shida M, Ikeda M, Kajiwara H, Matsui N, Fujita M, Muramatsu T, Mikami M (2013) Alterations of hypoxia-induced factor signaling pathway due to mammalian target of rapamycin (mTOR) suppression in ovarian clear cell adenocarcinoma: in vivo and in vitro explorations for clinical trial. Int J Gynecol Cancer 23(7):1210–1218CrossRefPubMed

19.

Al-Barrak J, Santos JL, Tinker A, Hoskins P, Gilks CB, Lau H, Swenerton KD (2011) Exploring palliative treatment outcomes in women with advanced or recurrent ovarian clear cell carcinoma. Gynecol Oncol 122(1):107–110CrossRefPubMed

20.

Itamochi H, Nishimura M, Oumi N, Kato M, Oishi T, Shimada M, Sato S, Naniwa J, Sato S, Kudoh A, Kigawa J, Harada T (2014) Checkpoint kinase inhibitor AZD7762 overcomes cisplatin resistance in clear cell carcinoma of the ovary. Int J Gynecol Cancer 24(1):61–69CrossRefPubMed

21.

Higashi M, Kajiyama H, Shibata K, Mizuno M, Mizuno K, Hosono S, Kawai M, Nakanishi T, Nagasaka T, Kikkawa F (2011) Survival impact of capsule rupture in stage I clear cell carcinoma of the ovary in comparison with other histological types. Gynecol Oncol 123(3):474–478CrossRefPubMed

22.

23.

Kajiyama H, Shibata K, Mizuno M, Hosono S, Kawai M, Nagasaka T, Kikkawa F (2011) Fertility-sparing surgery in cases with clear-cell carcinoma of the ovary: is it possible? Hum Reprod 26(12):3297–3302CrossRefPubMed

24.

Davis M, Rauh-Hain JA, Andrade C, Boruta DM 2nd, Schorge JO, Horowitz NS, May T, del Carmen MG (2014) Comparison of clinical outcomes of cases with clear cell and endometrioid ovarian cancer associated with endometriosis to papillary serous carcinoma of the ovary. Gynecol Oncol 132(3):760–766CrossRefPubMed

25.

Scarfone G, Bergamini A, Noli S, Villa A, Cipriani S, Taccagni G, Vigano’ P, Candiani M, Parazzini F, Mangilli G (2014) Characteristics of clear cell ovarian cancer arising from endometriosis: a two center cohort study. Gynecol Oncol 133(3):480–484CrossRefPubMed

26.

Cuff J, Longacre TA (2012) Endometriosis does not confer improved prognosis in ovarian carcinoma of uniform cell type. Am J Surg Pathol 36(5):688–695CrossRefPubMed

27.

McCluggage WG (2011) Morphological subtypes of ovarian carcinoma: a review with emphasis on new developments and pathogenesis. Pathology 43(5):420–432CrossRefPubMed

28.

Gulec UK, Paydas S, Guzel AB, Vardar MA, Urunsak IF, Cetin MT (2014) The relationship between ovarian volume and serum CA-125 levels. Eur J Gynaecol Oncol 35(3):280–283PubMed

29.

Ho CM, Chien TY, Shih BY, Huang SH (2003) Evaluation of complete surgical staging with pelvic and para-aortic lymphadenectomy and paclitaxel plus carboplatin chemotherapy for improvement of survival in stage I ovarian clear cell carcinoma. Gynecol Oncol 88(3):394–399CrossRefPubMed

30.

Kennedy AW, Biscotti CV, Hart WR, Webster KD (1989) Ovarian clear cell adenocarcinoma. Gynecol Oncol 32(3):342–349CrossRefPubMed

Title: The clinical characteristics and outcomes of cases with pure ovarian clear cell, mixed type and high-grade serous adenocarcinoma
Authors: Umran Kucukgoz Gulec
Semra Paydas
Ahmet Baris Guzel
Mehmet Ali Vardar
Ghanim Khatib
Derya Gumurdulu
Publication date: 01-10-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 4/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-015-3699-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The clinical characteristics and outcomes of cases with pure ovarian clear cell, mixed type and high-grade serous adenocarcinoma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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