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International Journal of Clinical Oncology

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01-10-2014 | Original Article

A recurrence-predicting prognostic factor for patients with ovarian clear-cell adenocarcinoma at reproductive age

Authors: Hiroaki Kajiyama, Mika Mizuno, Kiyosumi Shibata, Tomokazu Umezu, Shiro Suzuki, Eiko Yamamoto, Hiroko Mitsui, Ryuichiro Sekiya, Kaoru Niimi, Michiyasu Kawai, Tetsuro Nagasaka, Fumitaka Kikkawa

Published in: International Journal of Clinical Oncology | Issue 5/2014

Abstract

Objectives

We retrospectively analyzed the clinicopathological features and evaluated the prognostic indicators of recurrence in 132 patients with clear cell adenocarcinoma (CCC) of the ovary at reproductive age.

Patients and methods

Between 1986 and 2011, as a regional population-based study, clinicopathological data on 132 young patients with CCC, collected under the central pathological review system, were subjected to uni- and multivariable analyses to evaluate recurrence-free survival (RFS).

Results

The median age was 40 (27–45) years. The median follow-up period for surviving patients was 46.4 months. During the observation period, there were 16 recurrences in 87 patients with stage I tumors (18.4 %), 8 in 17 with stage II (47.1 %), and 16 in 28 with III–IV (57.1 %). Subsequently, 35 patients died of the disease. Those with stage I or II did not reach the median RFS. The median RFS of stage III–IV was 21.6 months. When analysis was confined to stage I patients, there was no significant difference in the RFS of CCC patients between IA and IC(r) (intraoperative capsule rupture) (P = 0.7957). In contrast, CCC patients with IC excluding IC(r) [IC(non-r)] showed a poorer RFS than those with IC(r) (P < 0.0001). In multivariable analysis confined to stage I patients, the substage group was only an independent prognostic factor for RFS [IA vs. IC(non-r)] [hazard ratio (HR) = 9.394; 95 % CI, 1.445–61.070; P = 0.0190].

Conclusion

We should keep in mind the greater risk of recurrence in patients with stage IC disease or higher, other than those stage IC patients with intraoperative rupture.

Japan Society of Obstetrics and Gynecology (2012). Acta Obstetricia Et Gynaecologia Japonica 64

Schiavone MB, Herzog TJ, Lewin SN et al (2011) Natural history and outcome of mucinous carcinoma of the ovary. Am J Obstet Gynecol 205(480):e481–e488

Czernobilsky B, Silverman BB, Enterline HT (1970) Clear-cell carcinoma of the ovary. A clinicopathologic analysis of pure and mixed forms and comparison with endometrioid carcinoma. Cancer 25:762–772PubMedCrossRef

Goff BA, Sainz de la Cuesta R, Muntz HG et al (1996) Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease. Gynecol Oncol 60:412–417PubMedCrossRef

Kennedy AW, Biscotti CV, Hart WR et al (1989) Ovarian clear cell adenocarcinoma. Gynecol Oncol 32:342–349PubMedCrossRef

Mizuno M, Kikkawa F, Shibata K et al (2006) Long-term follow-up and prognostic factor analysis in clear cell adenocarcinoma of the ovary. J Surg Oncol 94:138–143PubMedCrossRef

Suzuki S, Kajiyama H, Shibata K et al (2008) Is there any association between retroperitoneal lymphadenectomy and survival benefit in ovarian clear cell carcinoma patients? Ann Oncol Off J Eur Soc Med Oncol ESMO 19:1284–1287CrossRef

Duska LR, Chang YC, Flynn CE et al (1999) Epithelial ovarian carcinoma in the reproductive age group. Cancer 85:2623–2629PubMedCrossRef

Plaxe SC, Braly PS, Freddo JL et al (1993) Profiles of women age 30–39 and age less than 30 with epithelial ovarian cancer. Obstet Gynecol 81:651–654PubMed

10.

Rodriguez M, Nguyen HN, Averette HE et al (1994) National survey of ovarian carcinoma XII. Epithelial ovarian malignancies in women less than or equal to 25 years of age. Cancer 73:1245–1250PubMedCrossRef

11.

Smedley H, Sikora K (1985) Age as a prognostic factor in epithelial ovarian carcinoma. Br J Obstet Gynaecol 92:839–842PubMedCrossRef

12.

Swenerton KD, Hislop TG, Spinelli J, LeRiche JC et al (1985) Ovarian carcinoma: a multivariate analysis of prognostic factors. Obstet Gynecol 65:264–270PubMed

13.

Acta Obstetrica Et Gyaecologia Japonica (2012). 64:1076

14.

Kobayashi H, Sumimoto K, Moniwa N et al (2007) Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 17:37–43CrossRef

15.

Kobayashi H, Sumimoto K, Kitanaka T et al (2008) Ovarian endometrioma––risks factors of ovarian cancer development. Eur J Obstet Gynecol Reprod Biol 138:187–193PubMedCrossRef

16.

Olive DL (2003) Medical therapy of endometriosis. Sem Reprod Med 21:209–222CrossRef

17.

Kajiyama H, Shibata K, Suzuki S et al (2010) Fertility-sparing surgery in young women with invasive epithelial ovarian cancer. Eur J Surg Oncol 36:404–408PubMedCrossRef

18.

Chan JK, Urban R, Cheung MK et al (2006) Ovarian cancer in younger vs older women: a population-based analysis. Br J Cancer 95:1314–1320PubMedCrossRefPubMedCentral

19.

Komiyama S, Aoki D, Tominaga E et al (1999) Prognosis of Japanese patients with ovarian clear cell carcinoma associated with pelvic endometriosis: clinicopathologic evaluation. Gynecol Oncol 72:342–346PubMedCrossRef

20.

Vercellini P, Parazzini F, Bolis G et al (1993) Endometriosis and ovarian cancer. Am J Obstet Gynecol 169:181–182PubMedCrossRef

21.

Jenkins S, Olive DL, Haney AF (1986) Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol 67:335–338PubMed

22.

Redwine DB (1999) Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril 72:310–315PubMedCrossRef

23.

Sugiyama T, Kamura T, Kigawa J et al (2000) Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer 88:2584–2589PubMedCrossRef

24.

Takano M, Kikuchi Y, Yaegashi N et al (2006) Clear cell carcinoma of the ovary: a retrospective multicentre experience of 254 patients with complete surgical staging. Br J Cancer 94:1369–1374PubMedCrossRefPubMedCentral

25.

Higashi M, Kajiyama H, Shibata K et al (2011) Survival impact of capsule rupture in stage I clear cell carcinoma of the ovary in comparison with other histological types. Gynecol Oncol 123:474–478PubMedCrossRef

26.

Omura GA, Brady MF, Homesley HD et al (1991) Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 9:1138–1150PubMed

27.

Recio FO, Piver MS, Hempling RE et al (1996) Lack of improved survival plus increase in thromboembolic complications in patients with clear cell carcinoma of the ovary treated with platinum versus nonplatinum-based chemotherapy. Cancer 78:2157–2163PubMedCrossRef

28.

Kajiyama H, Shibata K, Mizuno M et al (2012) Postrecurrent oncologic outcome of patients with ovarian clear cell carcinoma. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 22:801–806CrossRef

29.

ACOG Practice Bulletin (2007) Management of adnexal masses. Obstet Gynecol 110:201–214CrossRef

30.

Aebi S, Castiglione M (2008) Epithelial ovarian carcinoma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 19(Suppl 2):ii14–ii16PubMed

31.

Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer (2013) NCCN clinical practice guidelines in oncology. www.nccn.com. Version 2.2013

32.

Kajiyama H, Shibata K, Mizuno M et al (2011) Fertility-sparing surgery in patients with clear-cell carcinoma of the ovary: is it possible? Hum Reprod 26:3297–3302PubMedCrossRef

33.

McGuire WP, Hoskins WJ, Brady MF et al (1996) Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 334:1–6PubMedCrossRef

34.

Takano M, Sugiyama T, Yaegashi N et al (2007) Progression-free survival and overall survival of patients with clear cell carcinoma of the ovary treated with paclitaxel-carboplatin or irinotecan-cisplatin: retrospective analysis. Int J Clin Oncol 12:256–260PubMedCrossRef

35.

Mizuno M, Kajiyama H, Shibata K et al (2012) Adjuvant chemotherapy for stage i ovarian clear cell carcinoma: is it necessary for stage IA? Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 22:1143–1149CrossRef

Title: A recurrence-predicting prognostic factor for patients with ovarian clear-cell adenocarcinoma at reproductive age
Authors: Hiroaki Kajiyama
Mika Mizuno
Kiyosumi Shibata
Tomokazu Umezu
Shiro Suzuki
Eiko Yamamoto
Hiroko Mitsui
Ryuichiro Sekiya
Kaoru Niimi
Michiyasu Kawai
Tetsuro Nagasaka
Fumitaka Kikkawa
Publication date: 01-10-2014
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 5/2014
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-013-0645-3

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Abstract

Objectives

Patients and methods

Results

Conclusion

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