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Prognostic factors in endometrial clear cell carcinoma

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To document the experience regarding patients treated for endometrial clear cell carcinoma (ECCC), with reference to clinical, biochemical, histopathologic, and prognostic features.

Material and methods

Twenty-six ECCC patients, diagnosed and treated between 2008 and 2014, were reviewed retrospectively. From the hospital records, all data related to patients’ demographic, clinical, biochemical, and histopathologic assessments and adjuvant therapy adjustments were evaluated. Disease-free survival (DFS), overall survival (OS), and 5-year cumulative survival rates (CSR) were estimated as well as prognostic factors associated with OS.

Results

The median follow-up time was 22.7 months, and the mean age at diagnosis was 64.0 years. Fourteen (53.8 %) women had early stage and 12 (46.2 %) women had advanced-stage disease. There were 17 (65.3 %) patients with pure clear cell carcinoma and 8 (30.7 %) patients with mixed histology on the hysterectomy specimen. Extra-uterine disease occurred more frequently in patients with pure ECCC and elevated CA-125 concentrations. Seventeen (65.3 %) patients received adjuvant platinum and taxane chemotherapy with (n: 13/17, 76.4 %) or without radiotherapy in the form of external beam radiotherapy (ERT) and/or vaginal brachytherapy (BRT). The rest of the patients (n: 9/26, 34.6 %), who had tumor with no or limited myometrial invasion without LVSI, impaired general health status, and non-compliance-to-post-operative treatment proposal received no adjuvant therapy. The mean DFS and OS were 49.54 and 50.01 months, respectively, with the 5-year CSR of 46.4 %. The mean OS was significantly shorter in patients with higher pre-operative CA-125 values, >2 cm tumor diameter, myometrial invasion ≥1/2, cervical involvement, uterine serosal and/or adnexal invasion, lymph node metastasis, and, thus, with advanced-stage disease. Uterine serosal invasion was the only significant prognostic factor associated with OS in the multivariate analysis.

Conclusion

Increased pre-operative serum CA-125 levels are associated with advanced-stage disease, and uterine serosal involvement is a significant prognostic factor associated with OS in women with ECCC.

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Acknowledgments

We thank Dr. Anita L. Akkas (PhD in English Literature) for contributing to the English editing.

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Authors and Affiliations

  1. Department of Gynecologic Oncology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Hamamonu, 06230, Ankara, Turkey

    Nilufer Cetinkaya, İlker Selcuk, Bulent Ozdal & Mehmet Mutlu Meydanli

  2. Department of Obstetrics and Gynecology, Hitit University Medical Faculty, Çorum, Turkey

    Tayfun Gungor

Authors
  1. Nilufer Cetinkaya
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  2. İlker Selcuk
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  3. Bulent Ozdal
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  4. Mehmet Mutlu Meydanli
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  5. Tayfun Gungor
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Corresponding author

Correspondence to Nilufer Cetinkaya.

Ethics declarations

The present study was approved by the Institutional Review Board of Zekai Tahir Burak Women’s Health Education and Research Hospital.

Conflict of interest

There is no conflict of interest, and the authors hereby declare that they have no competing financial interests.

Additional information

This study was carried out in the Department of Gynecologic Oncology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey.

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Cetinkaya, N., Selcuk, İ., Ozdal, B. et al. Prognostic factors in endometrial clear cell carcinoma. Arch Gynecol Obstet 295, 189–195 (2017). https://doi.org/10.1007/s00404-016-4183-x

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  • DOI: https://doi.org/10.1007/s00404-016-4183-x

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