Catherine A Shu1, Qin Zhou2, Anjali R Jotwani1, Alexia Iasonos2, Mario M Leitao3, Jason A Konner4, Carol A Aghajanian5. 1. Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 2. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 3. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA. 4. Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA. 5. Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA. Electronic address: aghajanc@mskcc.org.
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.
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.
Authors: Martin Köbel; Steve E Kalloger; David G Huntsman; Jennifer L Santos; Kenneth D Swenerton; Jeffrey D Seidman; C Blake Gilks Journal: Int J Gynecol Pathol Date: 2010-05 Impact factor: 2.762
Authors: Kimberly C Wiegand; Sohrab P Shah; Osama M Al-Agha; Yongjun Zhao; Kane Tse; Thomas Zeng; Janine Senz; Melissa K McConechy; Michael S Anglesio; Steve E Kalloger; Winnie Yang; Alireza Heravi-Moussavi; Ryan Giuliany; Christine Chow; John Fee; Abdalnasser Zayed; Leah Prentice; Nataliya Melnyk; Gulisa Turashvili; Allen D Delaney; Jason Madore; Stephen Yip; Andrew W McPherson; Gavin Ha; Lynda Bell; Sian Fereday; Angela Tam; Laura Galletta; Patricia N Tonin; Diane Provencher; Dianne Miller; Steven J M Jones; Richard A Moore; Gregg B Morin; Arusha Oloumi; Niki Boyd; Samuel A Aparicio; Ie-Ming Shih; Anne-Marie Mes-Masson; David D Bowtell; Martin Hirst; Blake Gilks; Marco A Marra; David G Huntsman Journal: N Engl J Med Date: 2010-09-08 Impact factor: 91.245
Authors: Michael J Callahan; Christopher P Crum; Fabiola Medeiros; David W Kindelberger; Julia A Elvin; Judy E Garber; Colleen M Feltmate; Ross S Berkowitz; Michael G Muto Journal: J Clin Oncol Date: 2007-09-01 Impact factor: 44.544
Authors: John K Chan; Chunqiao Tian; Gini F Fleming; Bradley J Monk; Thomas J Herzog; Daniel S Kapp; Jeffrey Bell Journal: Gynecol Oncol Date: 2009-11-28 Impact factor: 5.482
Authors: A Oseledchyk; M M Leitao; J Konner; R E O'Cearbhaill; D Zamarin; Y Sonoda; G J Gardner; K Long Roche; C A Aghajanian; R N Grisham; C L Brown; A Snyder; D S Chi; R A Soslow; N R Abu-Rustum; O Zivanovic Journal: Ann Oncol Date: 2017-12-01 Impact factor: 32.976