|
|
|
|
|
|
|
|
|
|
Low-Stage Ovarian Clear Cell Carcinoma: Population-Based Outcomes in British Columbia, Canada, With Evidence for a Survival Benefit As a Result of Irradiation
Abstract
Purpose
To evaluate the population-based outcomes of stage I and II ovarian clear cell carcinoma (OCCC) in a North American population
treated with carboplatin/paclitaxel and abdominopelvic irradiation.
Patients and Methods
Retrospective analysis was performed of 241 patients referred in the
carboplatin/paclitaxel era. Irradiation was to be used
with a few defined exceptions. However, because
of differing beliefs as to its effectiveness, its use was consistently
avoided
by specific oncologists, allowing the
opportunity to study its possible effect on disease-free survival (DFS)
in these concurrent
cohorts.
Results
Five- and
10-year DFS rates were 84% and 70% for stage IA/B; 67% and 57% for stage
IC; and 49% and 44% for stage II, respectively.
Five- and 10-year DFS rates for those with stage
IC disease based purely on rupture were similar to rates for patients
with
stage IA/B, at 92% and 71%, respectively.
The
remaining patients with stage IC had 48% 5- and 10-year DFS.
Multivariate analysis
using a decision tree identified positive
cytology as the most important factor (72% relapse rate if positive and
27% if negative
or unknown).
If, in addition, the capsule
surface was involved, then the relapse rate was 93%. Irradiation had no
discernible
survival benefit for patients with stage IA and
IC (rupture alone), whereas for the remainder of patients with stage IC
and
stage II, it improved DFS by 20% at 5 years
(relative risk, 0.5); the benefit was most evident in the cytologically
negative/unknown
group.
Conclusion
DFS is
similar in this North American population with early OCCC to the DFS
reported in Asia. A potential benefit from irradiation
was evident in a subset.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.