Skip to main content
SpringerLink
Log in

Clinical characteristics and prognostic factors of stage IC ovarian clear cell carcinoma: a Surveillance, Epidemiology, and End Results (SEER) analysis

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

Abstract

Purpose

The study aimed to investigate the clinical characteristics and prognostic factors of stage IC ovarian clear cell carcinoma (OCCC).

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was accessed for medical records of patients with stage IC OCCC from 1992 to 2016. The clinical and prognostic features of stage IC OCCC from several therapeutic perspectives were identified with Kaplan–Meier method and Cox proportional hazards model.

Results

Totally, 1079 patients were enrolled for the analysis. The median age was 55 (range 24–91) years. 850 (78.8%) patients were treated with chemotherapy, 877 (81.3%) received lymph node (LN) dissection, and 20 (1.9%) underwent radiotherapy. LN dissection (P = 0.501) and chemotherapy (P = 0.130) did not significantly impact cancer-specific survival (CSS). Among patients younger than 45 years, 23 received fertility-sparing surgery (FSS). No significant difference in CSS was observed between the FSS and non-FSS group (P = 0.523). Bilateral tumor (P < 0.001) and larger tumor size (P = 0.010) were significantly and independently associated with poor CSS. Older age (P = 0.001), bilateral tumor (P < 0.001), and larger tumor size (P = 0.005) were significantly and independently associated with poor overall survival (OS), while LN dissection (P = 0.005) was significantly and independently associated with better OS. Significant differences in CSS (P = 0.005) and OS (P < 0.001) were observed between the low- and high-risk groups, which were divided by median risk score.

Conclusion

LN dissection and chemotherapy did not significantly impact CSS, while LN dissection was an independent prognostic factor for OS. Convincing evidence from clinical trials with a large number of patients are further required to develop treatment guidelines.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Serov SFSR, Sobin LH (1973) International histologic classification of tumors. World Health Organization, Geneva

    Google Scholar 

  2. Machida H, Matsuo K, Yamagami W, Ebina Y, Kobayashi Y, Tabata T et al (2019) Trends and characteristics of epithelial ovarian cancer in Japan between 2002 and 2015: a JSGO-JSOG joint study. Gynecol Oncol 153:589–596

    Article  Google Scholar 

  3. Anglesio MS, Bashashati A, Wang YK, Senz J, Ha G, Yang W et al (2015) Multifocal endometriotic lesions associated with cancer are clonal and carry a high mutation burden. J Pathol 236:201–209

    Article  CAS  Google Scholar 

  4. Melamed A, Manning-Geist B, Bregar AJ, Diver EJ, Goodman A, Del Carmen MG et al (2017) Associations between residual disease and survival in epithelial ovarian cancer by histologic type. Gynecol Oncol 147:250–256

    Article  Google Scholar 

  5. Oliver KE, Brady WE, Birrer M, Gershenson DM, Fleming G, Copeland LJ et al (2017) An evaluation of progression free survival and overall survival of ovarian cancer patients with clear cell carcinoma versus serous carcinoma treated with platinum therapy: an NRG Oncology/Gynecologic Oncology Group experience. Gynecol Oncol 147:243–249

    Article  Google Scholar 

  6. Suzuki K, Takakura S, Saito M, Morikawa A, Suzuki J, Takahashi K et al (2014) Impact of surgical staging in stage I clear cell adenocarcinoma of the ovary. Int J Gynecol Cancer 24:1181–1189

    Article  Google Scholar 

  7. Morgan RJ Jr, Armstrong DK, Alvarez RD, Bakkum-Gamez JN, Behbakht K, Chen LM et al (2016) Ovarian cancer, version 1.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 14:1134–1163

    Article  Google Scholar 

  8. Ledermann JA, Raja FA, Fotopoulou C, Gonzalez-Martin A, Colombo N, Sessa C et al (2013) Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):24–32

    Article  Google Scholar 

  9. Prat J (2014) Oncology FCoG. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet 124:1–5

    Article  Google Scholar 

  10. Surveillance, Epidemiology, and End Results (SEER) Program:Incidence-SEER 18 Regs Custom Data(with additional treatment fields), Nov 2018 Sub (1975–2016 varying) National Cancer Institute, DCCPS, Surveillance Research Program, released April 2019, based on the November 2018 submission. https://seer.cancer.gov/

  11. Nasioudis D, Mastroyannis SA, Albright BB, Haggerty AF, Ko EM, Latif NA (2018) Adjuvant chemotherapy for stage I ovarian clear cell carcinoma: patterns of use and outcomes. Gynecol Oncol 150:14–18

    Article  Google Scholar 

  12. Takada T, Iwase H, Iitsuka C, Nomura H, Sakamoto K, Omatsu K et al (2012) Adjuvant chemotherapy for stage I clear cell carcinoma of the ovary: an analysis of fully staged patients. Int J Gynecol Cancer 22:573–578

    Article  Google Scholar 

  13. Bogani G, Ditto A, Lopez S, Bertolina F, Murgia F, Pinelli C et al (2020) Adjuvant chemotherapy vs. observation in stage I clear cell ovarian carcinoma: a systematic review and meta-analysis. Gynecol Oncol 157(1):293–298

    Article  CAS  Google Scholar 

  14. Shimizu D, Sato N, Sato T, Makino K, Kito M, Shirasawa H et al (2015) Impact of adjuvant chemotherapy for stage I ovarian carcinoma with intraoperative tumor capsule rupture. J Obstet Gynaecol Res 41:432–439

    Article  Google Scholar 

  15. Takano M, Sugiyama T, Yaegashi N, Suzuki M, Tsuda H, Sagae S et al (2009) The impact of complete surgical staging upon survival in early-stage ovarian clear cell carcinoma: a multi-institutional retrospective study. Int J Gynecol Cancer 19:1353–1357

    Article  Google Scholar 

  16. Yamazaki H, Todo Y, Shimada C, Takeshita S, Minobe S, Okamoto K et al (2018) Therapeutic significance of full lymphadenectomy in early-stage ovarian clear cell carcinoma. J Gynecol Oncol 29:e19

    Article  Google Scholar 

  17. Takano M, Kikuchi Y, Yaegashi N, Kuzuya K, Ueki M, Tsuda H et al (2006) Clear cell carcinoma of the ovary: a retrospective multicentre experience of 254 patients with complete surgical staging. Br J Cancer 94:1369–1374

    Article  CAS  Google Scholar 

  18. Park JY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH (2016) Outcomes of fertility-sparing surgery among young women with FIGO stage I clear cell carcinoma of the ovary. Int J Gynaecol Obstet 134:49–52

    Article  Google Scholar 

  19. Yoshihara M, Kajiyama H, Tamauchi S, Suzuki S, Takahashi K, Matsui S et al (2019) Prognostic factors and effects of fertility-sparing surgery in women of reproductive age with ovarian clear-cell carcinoma: a propensity score analysis. J Gynecol Oncol 30:e102

    Article  Google Scholar 

  20. Hogen L, Thomas G, Bernardini M, Bassiouny D, Brar H, Gien LT et al (2016) The effect of adjuvant radiation on survival in early stage clear cell ovarian carcinoma. Gynecol Oncol 143:258–263

    Article  Google Scholar 

  21. Ditto A, Martinelli F, Reato C, Kusamura S, Solima E, Fontanelli R et al (2012) Systematic para-aortic and pelvic lymphadenectomy in early stage epithelial ovarian cancer: a prospective study. Ann Surg Oncol 19:3849–3855

    Article  Google Scholar 

  22. Kuroda T, Kohno T (2020) Precision medicine for ovarian clear cell carcinoma based on gene alterations. Int J Clin Oncol 25:419–424

    Article  CAS  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People’s Republic of China

    Qian Chen, Shu Wang & Jing-He Lang

Authors
  1. Qian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jing-He Lang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Qian Chen: Data Collection, Manuscript writing/editing. Shu Wang: Project development, Manuscript editing. Jing-He Lang: Data analysis, Manuscript editing.

Corresponding authors

Correspondence to Shu Wang or Jing-He Lang.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Consent

Written informed consents were exempt since the data we used were obtained from the publicly available SEER database.

Ethics approval

All procedures performed in these studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was deemed exempt by the Ethics Committee of Peking Union Medical College Hospital, Beijing, China, since the data we used were obtained from the publicly available SEER database.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, Q., Wang, S. & Lang, JH. Clinical characteristics and prognostic factors of stage IC ovarian clear cell carcinoma: a Surveillance, Epidemiology, and End Results (SEER) analysis. Arch Gynecol Obstet 304, 521–529 (2021). https://doi.org/10.1007/s00404-020-05952-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05952-1

Keywords

Search

Navigation