Less Impact of Adjuvant Chemotherapy for Stage I Clear Cell Carcinoma of the Ovary: A Retrospective Japan Clear Cell Carcinoma Study. Issue 9 (1st November 2010)

• Record Type: Journal Article
• Authors: Takano, Masashi; Sugiyama, Toru; Yaegashi, Nobuo; Sagae, Satoru; Kuzuya, Kazuo; Udagawa, Yasuhiro; Tsuda, Hiroshi; Suzuki, Mitsuaki; Kigawa, Junzo; Goto, Tomoko; Tsuda, Hitoshi; Moriya, Takuya; Kikuchi, Yoshihiro
• Is Part Of: International journal of gynecological cancer. Volume 20:Issue 9(2010)
• Page Start: 1506
• Page End: 1510
• Publication Date: 2010-11-01
• Subjects: Ovarian cancer -- Clear cell carcinoma -- Adjuvant chemotherapy -- Peritoneal washing cytology; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1111/IGC.0b013e3181fcd089
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction: Ovarian clear cell carcinoma (CCC) is regarded as grade 3 tumor, and the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines recommend adjuvant chemotherapy for the tumor even at stage IA. However, CCC often showed chemo-resistant phenotype, and the effect of adjuvant chemotherapy still remained uncertain. Methods: Clear cell carcinoma cases treated at collaborating institutions during the period 1992-2005 were retrospectively identified. After a central pathological review, survival analysis was estimated by the Kaplan-Meier method, and prognostic factors were evaluated using a Cox regression model. Results: Among 219 patients with stage I CCC, 195 patients received adjuvant chemotherapy (C+) and 24 patients (C−) did not. The C+ group had 77 pT1a and 118 pT1c cases, and the C− group included 18 pT1a and 6 pT1c tumors ( P < 0.001). The median age was 52 years in the C+ group and 57 years in C− group ( P = 0.04). During the median follow-up period of 48 months (range, 7-160 years), relapse was observed in one patient (4%) in the C− group and in 35 patients (18%) in the C+ group. There were no statistical differences of progression-free survival and overall survival between the C+ and the C− groups. Multivariate analysis revealed that peritoneal cytology status ( P = 0.02) and pT status ( P = 0.04) were independent prognostic factors for progression-free survival; however, adjuvant chemotherapy was not a prognostic factor ( P = 0.80). Conclusions: Although the present study was a limited retrospective investigation, it suggested that adjuvant chemotherapy had little impact on the survival of stage I CCC patients. Further strategy, such as a molecular targeting agent, is needed to improve survival of CCC, especially in cases with positive peritoneal washing.