Impact of Surgical Staging in Stage I Clear Cell Adenocarcinoma of the Ovary. Issue 7 (1st September 2014)

• Record Type: Journal Article
• Authors: Suzuki, Kayo; Takakura, Satoshi; Saito, Motoaki; Morikawa, Asuka; Suzuki, Jiro; Takahashi, Kazuaki; Nagata, Chie; Yanaihara, Nozomu; Tanabe, Hiroshi; Okamoto, Aikou
• Is Part Of: International journal of gynecological cancer. Volume 24:Issue 7(2014)
• Page Start: 1181
• Page End: 1189
• Publication Date: 2014-09-01
• Subjects: Ovarian cancer -- Clear cell carcinoma -- Surgical staging -- Lymphadenectomy -- Adjuvant chemotherapy; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000178
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Aim: The aim of this study was to evaluate the impact of surgical staging in stage I clear cell adenocarcinoma of the ovary (CCC). Methods: We performed a retrospective review of 165 patients with stage I CCC treated with optimal or nonoptimal staging surgery. Results: The median follow-up period in this study was 67 months. No significant difference was detected in recurrence-free survival (RFS) or overall survival (OS) between patients optimally and nonoptimally staged (RFS: P = 0.434; OS: P = 0.759). The estimated 5-year RFS and OS rates were 92.1% and 95.3% in patients with stages IA/IC1 and 81.0% and 83.7% in stages IC2/IC3, respectively. The multivariate analysis indicated that stages IC2/IC3 predicted worse RFS and OS than stages IA/IC1 in stage I CCC patients (RFS: P = 0.011; OS: P = 0.011). Subsequently, we investigated the impact of surgical staging, respectively, in stages IA/IC1 and stages IC2/IC3. Significant differences were observed in PFS and OS between patients optimally and nonoptimally staged with stages IA/IC1 (RFS: P = 0.021; OS: P = 0.024), but no significant difference was found in those with stages IC2/IC3. The multivariate analysis indicated that nonoptimal staging surgery predicted worse RFS than the optimal staging surgery in stages IA/IC1 CCC patients ( P = 0.033). In addition, we investigated the impact of surgical staging for stages IA/IC1 in the adjuvant chemotherapy group. The 5-year RFS and OS rates in patients optimally and nonoptimally staged with stages IA/IC1 in the adjuvant chemotherapy group were 97.8% and 100%, and 85.2% and 89.4%, respectively. The multivariate analysis indicated that nonoptimal staging surgery predicted worse RFS than the optimal staging surgery for stages IA/IC1 patients in the adjuvant chemotherapy group ( P = 0.019). Conclusions: The prognosis for women with stage 1A/IC1 is very good. Surgical staging category was the only independent prognostic factor for RFS in stages IA/IC1 CCC.