Comparison of Clinical Characteristic and Survival Outcomes between Clear Cell and Non-Clear Cell Ovarian Cancer
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Abstract
Objectives: To compare clinical characteristics and survival outcomes between women with clear cell carcinoma (CCC) and non-clear cell (NCC) epithelium ovarian cancer.
Materials and Methods: A retrospective cohort study was conducted on 220 Epithelial ovarian cancer (EOC) patients at Buddhachinaraj Hospital between January 1999 and May 2017. The patient data were retrieved from medical records. The patient characteristic, operative findings, histologic types, chemotherapy, time of recurrence, and follow-up time were analyzed. The medical records were comprehensively reviewed. The Kaplan-Meier method and Cox regression were employed in the survival analyses.
Results: A total of 220 EOC patients were eligible in the study, comprising 63 cases of CCC and 150 cases of NCC. Patients with CCC were more presented stage I and met optimal cytoreduction (p < 0.005). The progression-free survival (PFS) and overall survival (OS) were not statistically different between CCC and NCC when analyzed in all stages. However, PFS and OS were significantly different when classified EOC into three groups: NCC type I, type II EOC, and CCC. In stage I, CCC had better PFS (p = 0.007), but OS was no significant difference (p = 0.279). In stage II-IV, CCC had a trend toward poorer 5-year OS than type II EOC. The optimal surgery and complete course of platinum-based chemotherapy were associated with better survival outcomes in patients with epithelial ovarian cancer (p < 0.001).
Conclusion: The prevalence of CCC was 29.65% of EOC patients, and the majority found stage I. The PFS and OS were not statistically different between CCC and NCC.
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References
Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M. et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144:1941-53.
Prat J. New insights into ovarian cancer pathology. Ann Oncol 2012;23 Suppl 10:x111-117.
Sung PL, Chang YH, Chao KC, Chuang CM. Global distribution pattern of histological subtypes of epithelial ovarian cancer: A database analysis and systematic review. Gynecol Oncol 2014;133:147-54.
Fuh KC, Shin JY, Kapp DS, Brooks RA, Ueda S, Urban RR. et al. Survival differences of Asian and Caucasian epithelial ovarian cancer patients in the United States. Gynecol Oncol 2015;136:491-7.
Peres LC, Risch H, Terry KL, Webb PM, Goodman MT, Wu AH. et al. Racial/ethnic differences in the epidemiology of ovarian cancer: a pooled analysis of 12 case-control studies. Int J Epidemiol 2018;47:460-72.
Jenison EL, Montag AG, Griffiths CT, Welch WR, Lavin PT, Greer J, et al. Clear cell adenocarcinoma of the ovary: a clinical analysis and comparison with serous carcinoma. Gynecol Oncol 1989;32:65-71.
Chan JK, Teoh D, Hu JM, Shin JY, Osann K, Kapp DS. Do clear cell ovarian carcinomas have poorer prognosis compared to other epithelial cell types? A study of 1411 clear cell ovarian cancers. Gynecol Oncol 2008;109:370-6.
Ku FC, Wu RC, Yang LY, Tang YH, Chang WY, Yang JE, et al. Clear cell carcinomas of the ovary have poorer outcomes compared with serous carcinomas: Results from a single-center Taiwanese study. J Formos Med Assoc 2018;117:117-25.
Kennedy AW, Markman M, Biscotti CV, Emery JD, Rybicki LA. Survival probability in ovarian clear cell adenocarcinoma. Gynecol Oncol 1999;74:108-14.
del Carmen MG, Birrer M, Schorge JO. Clear cell carcinoma of the ovary: A review of the literature. Gynecol Oncol 2012;126:481-90.
Kurman RJ, Shih Ie M. The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded. Am J Pathol 2016;186:733-47.
Sirichaisutdhikorn D, Suprasert P, Khunamornpong S. Clinical outcome of the ovarian clear cell carcinoma compared to other epithelial ovarian cancers when treated with paclitaxel and carboplatin. Asian Pac J Cancer Prev 2009;10:1041-5.
Jermsirisakpong W, Tuipae S. Survival outcomes between clear cell and non-clear cell epithelial ovarian cancer. Thai J Obstet Gynaecol 2013;21:32-40.
Machida H, Matsuo K, Yamagami W, Ebina Y, Kobayashi Y, Tabata T. et al. Trends and characteristics of epithelial ovarian cancer in Japan between 2002 and 2015: A JSGO JSOG joint study. Gynecol Oncol 2019;153:589-96.
Kim SI, Lim MC, Lim J, Won YJ, Seo SS, Kang S. et al. Incidence of epithelial ovarian cancer according to histologic subtypes in Korea, 1999 to 2012. J Gynecol Oncol 2016;27:e5.
Yen CF, Kim MR, Lee CL. Epidemiologic factors associated with endometriosis in East Asia. Gynecol Minim Invasive Ther 2019;8:4–11.
Lee WL, Chang WH, Wang KC, Guo CY, Chou YJ, Huang N. et al. The Risk of epithelial ovarian cancer of women with endometriosis may be varied greatly if diagnostic criteria are different: a nationwide population-based cohort study. Medicine (Baltimore) 2015;94:e1633.
Thomsen LH, Schnack TH, Buchardi K, Hummelshoj L, Missmer SA, Forman A, et al. Risk factors of epithelial ovarian carcinomas among women with endometriosis: a systematic review. Acta Obstet Gynecol Scand 2017;96:761-78.
Ogawa S, Kaku T, Amada S, Kobayashi H, Hirakawa T, Ariyoshi K, et al. Ovarian endometriosis associated with ovarian carcinoma: a clinicopathological and immunohistochemical study. Gynecol Oncol 2000;77:298-304.
Erzen M, Rakar S, Klancnik B, Syrjänen K. Endometriosis-associated ovarian carcinoma (EAOC): an entity distinct from other ovarian carcinomas as suggested by a nested case-control study. Gynecol Oncol 2001;83:100-8.
Buys SS, Partridge E, Black A, Johnson CC, Lamerato L, Isaacs C. et al. Effect of screening on ovarian cancer mortality: the prostate, lung, colorectal and ovarian (PLCO) cancer screening randomized controlled trial. JAMA 2011;305:2295-303.
Jacobs IJ, Menon U, Ryan A, Gentry-Maharaj A, Burnell M, Kalsi JK. et al. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet 2016;387:945-56.
Jacobs I, Bast RC Jr. The CA 125 tumour-associated antigen: a review of the literature. Hum Reprod 1989;4:1-12.
Suh DH, Chang SJ, Song T, Lee S, Kang WD, Lee SJ, et al. Practice guidelines for management of ovarian cancer in Korea: a Korean Society of Gynecologic Oncology Consensus Statement. J Gynecol Oncol 2018;29:e56.
Hippisley-Cox J, Coupland C. Identifying women with suspected ovarian cancer in primary care: derivation and validation of algorithm. BMJ 2011;344:d8009.
Moolthiya W, Yuenyao P. The risk of malignancy index (RMI) in diagnosis of ovarian malignancy. Asian Pac J Cancer Prev 2009;10:865-8.
Koshiyama M, Matsumura N, Konishi I. Recent concepts of ovarian carcinogenesis: type I and type II. Biomed Res Int 2014;2014:934261.
Salazar C, Campbell IG, Gorringe KL. When Is “Type I” ovarian cancer not “Type I” indications of an out-dated dichotomy. Front Oncol 2018;8:654.
Wu SG, Wang J, Sun JY, He ZY, Zhang WW, Zhou J. Real-world impact of survival by period of diagnosis in epithelial ovarian cancer between 1990 and 2014. Front Oncol 2019;9:639.
Colombo N, Sessa C, du Bois A, Ledermann J, McCluggage WG, McNeish I, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol 2019;30:672-705.
Oliver KE, Brady WE, Birrer M, Gershenson DM, Fleming G, Copeland LJ. et al. An evaluation of progression free survival and overall survival of ovarian cancer patients with clear cell carcinoma versus serous carcinoma treated with platinum therapy: An NRG Oncology/Gynecologic Oncology Group experience. Gynecol Oncol 2017;147:243-9.
Chang LC, Huang CF, Lai MS, Shen LJ, Wu FL, Cheng WF. Prognostic factors in epithelial ovarian cancer: A population-based study. PLoS One 2018;13: e0194993.