Fertility sparing surgery for early-stage clear cell carcinoma of the ovary; A systematic review and analysis of obstetric outcomes

2021 ◽  
Author(s):  
Anastasia Prodromidou ◽  
Charalampos Theofanakis ◽  
Nikolaos Thomakos ◽  
Dimitrios Haidopoulos ◽  
Alexandros Rodolakis
Keyword(s):  
Systematic Review ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Early Stage ◽  
Obstetric Outcomes ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Carcinoma Of The Ovary

Is there any possibility of fertility-sparing surgery in patients with clear-cell carcinoma of the ovary?

2008 ◽  
Vol 111 (3) ◽  
pp. 523-526 ◽  
Author(s):  
Hiroaki Kajiyama ◽  
Kiyosumi Shibata ◽  
Shiro Suzuki ◽  
Kazuhiko Ino ◽  
Eiko Yamamoto ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Carcinoma Of The Ovary

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

2020 ◽  
Vol 30 (9) ◽  
pp. 1372-1377 ◽  
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.

Outcomes of fertility-sparing surgery among young women with FIGO stage I clear cell carcinoma of the ovary

2016 ◽  
Vol 134 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Jeong-Yeol Park ◽  
Dae-Shik Suh ◽  
Jong-Hyeok Kim ◽  
Yong-Man Kim ◽  
Young-Tak Kim ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Young Women ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Figo Stage ◽  
Stage I ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Carcinoma Of The Ovary

scholarly journals Could fertility-sparing surgery be considered for women with early stage ovarian clear cell carcinoma?

2017 ◽  
Vol 28 (6) ◽  
Author(s):  
Dimitrios Nasioudis ◽  
Eloise Chapman-Davis ◽  
Melissa K. Frey ◽  
Steven S. Witkin ◽  
Kevin Holcomb
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Early Stage ◽  
Ovarian Clear Cell Carcinoma ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing

scholarly journals Fertility-sparing surgery in patients with clear-cell carcinoma of the ovary: Is it possible?

2011 ◽  
Vol 26 (12) ◽  
pp. 3297-3302 ◽  
Author(s):  
H. Kajiyama ◽  
K. Shibata ◽  
M. Mizuno ◽  
S. Hosono ◽  
M. Kawai ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Carcinoma Of The Ovary

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

2020 ◽  
Author(s):  
Xia Yin ◽  
Jie Cheng ◽  
Yi Zhang ◽  
Chee Wai Chua ◽  
Cheng Zhou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cell Carcinoma ◽  
Odds Ratio ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Early Stage ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Progression Free Survival ◽  
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 : 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.

scholarly journals Clear cell carcinoma of the ovary: a clinical and molecular perspective

2020 ◽  
pp. ijgc-2020-001656
Author(s):  
Yasushi Iida ◽  
Aikou Okamoto ◽  
Robert L Hollis ◽  
Charlie Gourley ◽  
C Simon Herrington
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Early Stage ◽  
Molecular Characteristics ◽  
Specific Gene ◽  
Tumor Type ◽  
Early Stage Disease ◽  
Platinum Based Chemotherapy ◽  
Carcinoma Of The Ovary

Clear cell carcinoma of the ovary has distinct biology and clinical behavior. There are significant geographical and racial differences in the incidence of clear cell carcinoma compared with other epithelial ovarian tumors. Patients with clear cell carcinoma are younger, tend to present at an early stage, and their tumors are commonly associated with endometriosis, which is widely accepted as a direct precursor of clear cell carcinoma and has been identified pathologically in approximately 50% of clear cell carcinoma cases. The most frequent and important specific gene alterations in clear cell carcinoma are mutations of AT-rich interaction domain 1A (ARID1A) (~50% of cases) and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) (~50% cases). More broadly, subgroups of clear cell carcinoma have been identified based on C-APOBEC (apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like) and C-AGE (age-related) mutational signatures. Gene expression profiling shows upregulation of hepatocyte nuclear factor 1-beta (HNF1β) and oxidative stress-related genes, and has identified epithelial-like and mesenchymal-like tumor subgroups. Although the benefit of platinum-based chemotherapy is not clearly defined it remains the mainstay of first-line therapy. Patients with early-stage disease have a favorable clinical outcome but the prognosis of patients with advanced-stage or recurrent disease is poor. Alternative treatment strategies are required to improve patient outcome and the development of targeted therapies based on molecular characteristics is a promising approach. Improved specificity of the histological definition of this tumor type is helping these efforts but, due to the rarity of clear cell carcinoma, international collaboration will be essential to design appropriately powered, large-scale clinical trials.

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