Uterine carcinosarcoma vs endometrial serous and clear cell carcinoma: a systematic review and meta‐analysis of survival

Abstract Background : Uterine clear cell carcinoma (UCCC) is a rare histological type of endometrial cancer with poor prognosis and high risk of tumor relapse. Although adjuvant chemotherapy (CT) and/or radiotherapy (RT) are often recommended for early stage UCCC patients, the effectiveness of these treatment strategies remains unclear. Methods : Systematic review and meta-analysis were applied to evaluate treatment-related outcomes of stage I-II UCCC patients. Search strategy was applied using electronic databases until June 1st, 2019. Inclusion criteria were retrospective, observational and prospective studies that reported outcome of UCCC patients receiving adjuvant therapy. Clinical endpoints like overall survival (OS) and progression-free survival (PFS) were evaluated. Data were extracted by two independent reviewers and a meta-analysis was performed. Results : 13 articles with a total of 3967 patients were analyzed. Overall, adjuvant CT after surgery could improve 5 year-OS significantly compared to patients without CT (odds ratio 0.75, 95% confidence interval [CI] 0.58-0.96; p=0.02). In comparison, RT could also improve OS in UCCC patients of early stage (odds ratio 0.58, 95% CI 0.44-0.77; p=0.0002) compared to the patients without RT, especially in US and Europe patients. Lastly, when comparing the patients undergoing both CT and RT with those receiving CT or RT alone, no further improvement in OS was observed (odds ratio 1.12, 95% CI 0.63-1.99; P=0.70). Conclusions : Either CT or RT after surgery could improve the OS of early stage of UCCC patients. However, combinatorial CT and RT treatment did not improve the OS compared with CT or RT treatment alone.

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Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

10.21203/rs.2.20417/v4 ◽

2020 ◽

Keyword(s):

Systematic Review ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Meta Analysis ◽

Uterine Clear Cell Carcinoma

Abstract The authors have requested that this preprint be withdrawn due to erroneous posting.

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Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

10.21203/rs.2.20417/v3 ◽

2020 ◽

Author(s):

Jie Cheng ◽

Guanglei Zhuang ◽

Cheng Zhou ◽

Chee Wai Chua ◽

Yi Zhang ◽

...

Keyword(s):

Systematic Review ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Meta Analysis ◽

Treatment Strategies ◽

Progression Free Survival ◽

Clinical Endpoints ◽

Uterine Clear Cell Carcinoma

Abstract Background: Uterine clear cell carcinoma (UCCC) is a rare histological type of endometrial cancer with poor prognosis and high risk of tumor relapse. Although adjuvant chemotherapy (CT) and/or radiotherapy (RT) are often recommended for early stage UCCC patients, the effectiveness of these treatment strategies remains unclear. Methods: Systematic review and meta-analysis were applied to evaluate treatment-related outcomes of stage I-II UCCC patients. Search strategy was applied using electronic databases until June 1st, 2019. Inclusion criteria were retrospective, observational and prospective studies that reported outcome of UCCC patients receiving adjuvant therapy. Clinical endpoints like overall survival (OS) and progression-free survival (PFS) were evaluated. Data were extracted by two independent reviewers and a meta-analysis was performed. Results: 12 articles with a total of 3845 patients were analyzed. Overall, adjuvant CT after surgery could improve 5 year-OS significantly compared to patients without CT (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.58-0.95; p=0.02). In comparison, RT could also improve OS in UCCC patients of early stage (OR: 0.61, 95% CI: 0.46-0.82; p=0.001) compared to the patients without RT, in US and Europe patients. Lastly, when comparing the patients undergoing both CT and RT with those receiving CT or RT alone, no further improvement in OS was observed (OR: 0.95, 95% CI: 0.53-1.72; P=0.88). Conclusions: Either CT or RT after surgery could improve the OS of early stage of UCCC patients. However, combinatorial CT and RT treatment did not improve the OS compared with CT or RT treatment alone.

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Outcomes in patients with early stage uterine clear cell carcinoma treated with chemotherapy and radiotherapy: A systematic review and meta-analysis

10.21203/rs.2.20417/v2 ◽

2020 ◽

Author(s):

Jie Cheng ◽

Guanglei Zhuang ◽

Cheng Zhou ◽

Chee Wai Chua ◽

Yi Zhang ◽

...

Keyword(s):

Systematic Review ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Meta Analysis ◽

Treatment Strategies ◽

Progression Free Survival ◽

Clinical Endpoints ◽

Uterine Clear Cell Carcinoma

Abstract Background : Uterine clear cell carcinoma (UCCC) is a rare histological type of endometrial cancer with poor prognosis and high risk of tumor relapse. Although adjuvant chemotherapy (CT) and/or radiotherapy (RT) are often recommended for early stage UCCC patients, the effectiveness of these treatment strategies remains unclear. Methods : Systematic review and meta-analysis were applied to evaluate treatment-related outcomes of stage I-II UCCC patients. Search strategy was applied using electronic databases until June 1st, 2019. Inclusion criteria were retrospective, observational and prospective studies that reported outcome of UCCC patients receiving adjuvant therapy. Clinical endpoints like overall survival (OS) and progression-free survival (PFS) were evaluated. Data were extracted by two independent reviewers and a meta-analysis was performed. Results : 12 articles with a total of 3845 patients were analyzed. Overall, adjuvant CT after surgery could improve 5 year-OS significantly compared to patients without CT (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.58-0.95; p=0.02). In comparison, RT could also improve OS in UCCC patients of early stage (OR: 0.61, 95% CI: 0.46-0.82; p=0.001) compared to the patients without RT, in US and Europe patients. Lastly, when comparing the patients undergoing both CT and RT with those receiving CT or RT alone, no further improvement in OS was observed (OR: 0.95, 95% CI: 0.53-1.72; P=0.88). Conclusions : Either CT or RT after surgery could improve the OS of early stage of UCCC patients. However, combinatorial CT and RT treatment did not improve the OS compared with CT or RT treatment alone.

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The impact of lymphadenectomy on survival outcomes of ovarian clear cell carcinoma: a systematic review and meta-analysis

10.22541/au.163878530.06346775/v1 ◽

2021 ◽

Author(s):

Yan Liu ◽

Changzhen Huang ◽

Ran Chu ◽

Xingsheng Yang ◽

Beihua Kong ◽

...

Keyword(s):

Systematic Review ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Meta Analysis ◽

Treatment Strategies ◽

Disease Free Survival ◽

Ovarian Clear Cell Carcinoma ◽

Free Survival ◽

The Impact

Background: The treatment strategies for ovarian clear cell carcinoma (OCCC) are the same as those for epithelial ovarian cancer. Due to the rarity of OCCC, no prospective studies of its surgery have been reported. Therefore, the therapeutic significance of lymphadenectomy for OCCC needs to be further clarified. Objectives: To assess the effectiveness of lymphadenectomy in patients with ovarian clear cell carcinoma by a meta-analysis. Search Strategy: The Web of Science, Scopus, PubMed, and other sources (e.g. Google Scholar) were searched from each database’s earliest inception to June 2021. Selection Criteria: English-language publications of observational studies that investigated the role of lymphadenectomy in patients with OCCC were included. Data Collection and Analysis: The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated. Main Results: The analysis demonstrated that lymphadenectomy is associated with significantly improved disease-specific survival (DSS) (HR=0.76; 95%CI=0.60-0.95; P=0.02; I2= 0.0%) and disease-free survival (DFS) (HR=0.58; 95%CI=0.33-1.00; P=0.05; I2=61%), but not for overall survival (OS) (HR=0.80; 95%CI=0.60-1.06; P=0.12; I2= 19%) and progression-free survival (PFS) (HR=0.95; 95%CI=0.64-1.42; P=0.79; I2= 0.0%). But it is worth noting that several single studies indicated a tendency of improved OS, PFS, DFS, DSS with lymphadenectomy. Conclusions: Lymphadenectomy could not significantly improve OS and PFS for OCCC, but is associated with improved DFS and DSS. Gynecologic oncologists should tailor treatment to patients to achieve optimal outcomes. And further studies are necessary to validate the impact of lymphadenectomy on OCCC. Keywords: ovarian clear cell carcinoma, lymphadenectomy, survival, systematic review, meta- analysis

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Prognosis of ovarian clear cell carcinoma compared to other histological subtypes: A meta-analysis

Gynecologic Oncology ◽

10.1016/j.ygyno.2011.05.009 ◽

2011 ◽

Vol 122 (3) ◽

pp. 541-547 ◽

Cited By ~ 54

Author(s):

Yoo-Young Lee ◽

Tae-Joong Kim ◽

Min-Ji Kim ◽

Ha-Jeong Kim ◽

Taejong Song ◽

...

Keyword(s):

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Meta Analysis ◽

Ovarian Clear Cell Carcinoma ◽

Histological Subtypes

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Response to systemic therapy in non-clear cell renal cell carcinomas: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.425 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 425-425 ◽

Cited By ~ 5

Author(s):

Francisco Emilio Vera-Badillo ◽

Arnoud Templeton ◽

Alberto Ocana ◽

Paulo deGouveia ◽

Priya Aneja ◽

...

Keyword(s):

Systematic Review ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Systemic Therapy ◽

Renal Cell ◽

Overall Response Rate ◽

Response Rate ◽

Clear Cell ◽

Meta Analysis ◽

Cell Renal Cell Carcinoma

425 Background: Clinical data supporting the efficacy of systemic therapy in non-clear cell renal cell carcinoma (non-ccRCC) are limited and based on retrospective analyses, expanded access programs and single arm phase II trials. Therefore the optimal treatment for this subgroup remains uncertain. Methods: A systematic review of electronic databases was conducted to identify publications evaluating the outcomes of patients with non-ccRCC (excluding those with sarcomatoid tumors) treated with different systemic approaches (immunotherapy, chemotherapy, targeted agents, small molecules). The primary endpoint was response rate and secondary endpoints were median progression free (PFS) and overall survival (OS). Where possible, data were pooled in a meta-analysis using the Mantel-Haenszel random-effect modeling. For studies comprising of unselected patients, outcomes of those with non-ccRCC were compared with clear cell renal cell carcinoma (ccRCC). Results: Forty-nine studies comprising 7,799 patients were included: 471 patients were enrolled on studies conducted exclusively in non-ccRCC and 7,328 patients on studies of unselected renal cell carcinoma. Among these, 903 (12%) had non-ccRCC and 6,425 (88%) had ccRCC. For non-ccRCC, overall response rate, median PFS and median OS were 9%, 7.9 and 13.4 months, respectively. By comparison, the overall response rate for ccRCC was 15% (Risk Ratio for response [RR] 0.67, 95% CI 0.52-0.86, p=0.002). This association was independent of type of treatment administered. Among the different novel agents (bevacizumab, lenalidomide, linefanib, sorafenib, sunitinib, pazopanib, everolimus and temsirolimus), sunitinib was significantly less efficacious in non-ccRCC than ccRCC (RR 0.56, 95% CI 0.42-0.72), but there was no significant difference in response rates for sorafenib (RR 0.64, 95% CI 0.31-1.35) or other agents (RR 1.10, 95% CI 0.50-2.44), However, confidence intervals were wide. Results of further analyses will be presented at the meeting. Conclusions: Patients with non-ccRCC have lower response rates than those with ccRCC, but the absolute difference between them is modest. Further study of targeted therapy in non-ccRCC is warranted.

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Fertility sparing surgery for patients with FIGO stage I clear cell ovarian carcinoma: a database analysis and systematic review of the literature

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001716 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1372-1377 ◽

Cited By ~ 1

Author(s):

Dimitrios Nasioudis ◽

Lakeisha Mulugeta-Gordon ◽

Erin McMinn ◽

Melissa K Frey ◽

Eloise Chapman-Davis ◽

...

Keyword(s):

Systematic Review ◽

Overall Survival ◽

Cell Carcinoma ◽

Clear Cell ◽

Radical Surgery ◽

Clear Cell Carcinoma ◽

Stage I ◽

Ovarian Clear Cell Carcinoma ◽

Fertility Sparing Surgery ◽

Fertility Sparing

ObjectiveFertility sparing surgery for patients with early stage ovarian clear cell carcinoma is controversial. We aimed to investigate the impact of fertility sparing surgery on the oncologic outcomes of young patients with stage I ovarian clear cell carcinoma.MethodsThe National Cancer Database was accessed and patients with pathological stage IA or IC ovarian clear cell carcinoma, aged <45 years, were selected. Based on site specific surgery codes, patients who underwent fertility sparing or radical surgery were identified. Overall survival was evaluated following generation of Kaplan–Meier curves, and compared with the log rank test. Multivariate Cox analysis was performed to control for possible confounders. A systematic review of literature of the Pubmed, EMBASE and Web of Science databases was also performed to summarize all reported cases.ResultsA total of 57 (35.8%) and 102 (64.2%) patients underwent fertility sparing and radical surgery. There was no difference in overall survival between patients who had fertility sparing and radical surgery (p=0.92); 5 year overall survival rates were 89% and 87.9%, respectively. After controlling for the performance of lymphadenectomy and disease substage, fertility sparing surgery was not associated with worse survival (hazard ratio 0.83, 95% confidence interval 0.30 to 2.32). A systematic review of the literature identified 132 patients with stage I disease who underwent fertility sparing surgery; a total of 20 patients (15.2%) experienced a relapse at a median of 18 months from surgery.ConclusionsIn a large cohort of young patients with stage I ovarian clear cell carcinoma, fertility sparing surgery was not associated with worse survival.

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