Jennifer A Bennett1, Fei Dong, Robert H Young, Esther Oliva. 1. James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Boston, MA, USA; Department of Pathology, Harvard Medical School, Boston, MA, USA.
Abstract
AIMS: The aim of this study was to evaluate the clinicopathological features of ovarian clear cell carcinomas in order to identify which, if any, are prognostically significant, and to determine whether there is value in grading these tumours. METHODS AND RESULTS: One hundred tumours with clinical follow-up were reviewed. Features evaluated included age, preoperative/intraoperative rupture, size, architectural pattern(s), presence of oxyphilic cells, degree of cytological atypia, nucleolar grade, mitoses, background precursor and stage. Survival differences were analysed using the log-rank test and Kaplan-Meier estimator. Stage and lymph node status were the only parameters that were statistically significant (P < 0.0001). Patients with stage I disease (71%) had a 92% 5-year survival compared to a 31% 5-year survival in advanced stage disease (29%). Those with negative lymph nodes (92%) had an 80% 5-year survival compared to a 22% 5-year survival for those with positive nodes (8%). CONCLUSIONS: This study shows that stage and lymph node status are the only prognostically significant parameters in patients with ovarian clear cell carcinoma. It also confirms that most patients with clear cell carcinoma present with disease confined to the ovary, and have an excellent prognosis. Grading ovarian clear cell carcinomas based on morphological features is not recommended, as none are of prognostic significance.
AIMS: The aim of this study was to evaluate the clinicopathological features of ovarian clear cell carcinomas in order to identify which, if any, are prognostically significant, and to determine whether there is value in grading these tumours. METHODS AND RESULTS: One hundred tumours with clinical follow-up were reviewed. Features evaluated included age, preoperative/intraoperative rupture, size, architectural pattern(s), presence of oxyphilic cells, degree of cytological atypia, nucleolar grade, mitoses, background precursor and stage. Survival differences were analysed using the log-rank test and Kaplan-Meier estimator. Stage and lymph node status were the only parameters that were statistically significant (P < 0.0001). Patients with stage I disease (71%) had a 92% 5-year survival compared to a 31% 5-year survival in advanced stage disease (29%). Those with negative lymph nodes (92%) had an 80% 5-year survival compared to a 22% 5-year survival for those with positive nodes (8%). CONCLUSIONS: This study shows that stage and lymph node status are the only prognostically significant parameters in patients with ovarian clear cell carcinoma. It also confirms that most patients with clear cell carcinoma present with disease confined to the ovary, and have an excellent prognosis. Grading ovarian clear cell carcinomas based on morphological features is not recommended, as none are of prognostic significance.
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