abstract
OBJECTIVE:
Ovarian
clear cell carcinomas (OCCCs) are rare, and uncertainty exists as to
the optimal treatment paradigm and validity of the FIGO staging system,
especially in early-stage disease.
METHODS:
We
performed a retrospective cohort study of all OCCC patients diagnosed
and treated at Memorial Sloan Kettering Cancer Center between
January
1996 and December 2013. Progression-free survival (PFS) and overall
survival (OS) were calculated by stage and race, and comparisons were
made using the log-rank test. Statistical significance was set at
p<0.05. Type and duration of treatment were also recorded.
RESULTS:
There
were 177 evaluable patients. The majority of patients were stage I at
diagnosis (110/177, 62.2%). Of these, 60/110 (54.6%) were stage IA,
31/110 (28.2%) were stage IC on the basis of rupture-only, and 19/110
(17.3%) were stage IC on the basis of surface involvement and/or
positive cytology of ascites or washings. Patients with stage IA and IC
based on rupture-only had similar PFS/OS outcomes. Patients with stage
IC based on surface involvement and/or positive cytology had a
statistically significant decrement in PFS/OS. Stage was an important
indicator of PFS/OS, while race was not.
CONCLUSIONS:
OCCC
often presents in early stage. Women with stage IA OCCC have excellent
prognosis, and future studies should explore whether they benefit from
adjuvant chemotherapy. Women with IC OCCC need further staging
clarification, as surgical rupture alone affords better prognosis than
surface involvement and/or positive cytology. Women with advanced OCCC
have poor survival and are often chemotherapy resistant/refractory. New
treatment paradigms are needed.
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