Tatalaksana Radioterapi pada Kekambuhan Lokal Kanker Ovarium Clear Cell

Clear Cell Carcinoma is a rare subtype of ovarian cancer. At early stage ovarian cancer were not exhibit symptoms, most of case were found at advanced stage. Treatments for advanced stage ovarian cancer are cytoreduction surgery and carboplatin and paclitaxel adjuvant chemotherapy. Cancer stem cells resilient and chemoresistants phenotype of clear cell carcinoma were responsible for local relapse. Radiotherapy with palliative intents can alleviate symptoms and increase quality of life, radiotherapy can also be given curatively for local relapse. Brachytherapy as dose escalation is recommended for limited and locally tumor residue.

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FS-C4BP (fully-sialylated alpha-chain of complement 4-binding protein) is a novel biomarker that can detect early stage epithelial ovarian cancer, especially clear cell carcinoma

10.26226/morressier.5770e29dd462b80290b4c232 ◽

2016 ◽

Author(s):

Masae Ikeda

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Binding Protein ◽

Alpha Chain ◽

Complement 4

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An evaluation of survival of ovarian cancer patients with clear cell carcinoma versus serous carcinoma treated with platinum therapy: A Gynecologic Oncology Group experience.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5534 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5534-5534 ◽

Cited By ~ 1

Author(s):

John H. Farley ◽

William E. Brady ◽

Michael J. Birrer ◽

David Marc Gershenson ◽

Gini F. Fleming ◽

...

Keyword(s):

Ovarian Cancer ◽

Prognostic Factors ◽

Epithelial Ovarian Cancer ◽

Cell Carcinoma ◽

Treatment Effect ◽

Late Stage ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Performance Status

5534 Background: We examined disparities in prognosis between patients with ovarian clear cell carcinoma (OCCC) and serous epithelial ovarian cancer (SOC). Methods: Data from stage I-IV epithelial ovarian cancer (EOC) patients who participated in 12 randomized GOG protocols using platinum-based chemotherapy were reviewed. Proportional hazards models adjusted for age and stratified by protocol, treatment arm, stage, performance status (PS), and race were used to compare progression-free survival (PFS) and overall survival (OS) by cell type (clear cell versus serous). Results: There were 10,803 patients enrolled, 1272 were not eligible: leaving 9,531, of whom 544 (6%) had OCCC, 7,054 (74%) had SOC, and 1,933 (20%) had other; only the OCCC and SOC are considered here. OCCC were significantly younger, more often of Asian race, stage I, good PS, and optimally surgically debulked than SOC patients. Prior to adjustment, OCCC had better PFS and OS due to better prognostic factors. There was no significant difference in PFS or OS for early stage OCCC patients compared to high-grade (HG) SOC patients. For late stage patients, OCCC had poorer PFS and OS compared to SOC, OS HR= 1.66 (1.43, 1.91; p < 0.001). For both optimal, HR = 1.34 (1.10, 1.63; p = 0.003) and suboptimal, HR = 3.18 (2.13, 4.75; p < 0.001) OCCC had a significantly poorer OS than SOC. After adjusting for age and stratified by protocol and treatment arm, stage, performance status, and race, OCCC had a significantly decreased OS, HR= 1.53 (1.33,1.76; p < 0.001). In early stage cases, there was a significantly decreased treatment effect on PFS for consolidative therapy with weekly taxol versus observation in SOC compared to OCCC (p = 0.048). Conclusions: This is one of the largest analyses to date of OCCC treated in a uniform manner . OCCC patients have better PFS and OS compared to SOC; this, is due to their better prognostic factors. There was no observed difference in PFS or OS for early stage OCCC versus HGSOC. In late-stage patients, OCCC was significantly associated with decreased OS which was true for both optimal and suboptimally debulked patients. Finally, treatment effect was influenced by histology.

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Uterine Clear Cell Carcinoma: Does Adjuvant Chemotherapy Improve Outcomes?

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000839 ◽

2016 ◽

Vol 27 (1) ◽

pp. 69-76 ◽

Cited By ~ 3

Author(s):

Julie M.V. Nguyen ◽

Geneviève Bouchard-Fortier ◽

Marcus Q. Bernardini ◽

Eshetu G. Atenafu ◽

Guangming Han ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Stage I ◽

High Rate ◽

Advanced Stage ◽

Early Stage Disease ◽

Uterine Clear Cell Carcinoma

ObjectivesWomen with uterine clear cell carcinoma (UCCC) are at high risk of relapse. Adjuvant chemotherapy (CT) is often recommended, although its effectiveness remains controversial. Our objective was to evaluate treatment-related outcomes of patients with UCCC, particularly those treated with adjuvant CT.MethodsIn this retrospective cohort study, patients diagnosed with UCCC at 2 academic cancer centers from 2000 to 2014 were included. Clinical, surgical, and pathological data were collected. Survival estimates were obtained using the Kaplan-Meier method and compared by log rank test. Multivariable analysis was used to determine the effect of CT and radiation therapy (RT) on overall survival (OS) and progression-free survival (PFS).ResultsWe included 146 patients with UCCC, with a median follow-up of 27 months (range, 1–160). Ninety-five (65%) patients presented with stage I to II disease and 51 (35%) with stage III to IV disease. Forty-six percent of patients with clinical stage I were upstaged after surgery: 29% were upstaged to stages III and IV. Thirty-one percent of patients with early-stage disease and 70% with advanced-stage received CT. Among recurrences, the majority had distant relapse in both early-stage (61.5%) and advanced-stage (96.3%) diseases. In both patients with early-stage and advanced-stage diseases, adjuvant CT did not improve OS or PFS. On multivariate analysis, CT was not a significant factor associated with improved PFS (hazard ratio [HR], 1.37; 95% confidence interval [CI], 0.69–2.71;P= 0.37) or OS (HR, 0.58; 95% CI, 0.24–1.38;P= 0.22), whereas RT was associated with improved PFS (HR, 0.51; 95% CI, 0.29–0.90;P= 0.02) and OS (HR, 0.19; 95% CI, 0.09–0.42;P< 0.001).ConclusionsThe high rate of upstaging after surgery highlights the importance of lymph node assessment. The high rate of distant recurrence questions the effectiveness of current CT regimens and warrants the development of novel systemic approaches. The role of adjuvant RT deserves further study.

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Frequent PIK3CA mutations in eutopic endometrium of patients with ovarian clear cell carcinoma

Modern Pathology ◽

10.1038/s41379-021-00861-3 ◽

2021 ◽

Author(s):

Kosuke Murakami ◽

Akiko Kanto ◽

Kazuko Sakai ◽

Chiho Miyagawa ◽

Hisamitsu Takaya ◽

...

Keyword(s):

Ovarian Cancer ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Driver Mutations ◽

Intratumor Heterogeneity ◽

Ovarian Clear Cell Carcinoma ◽

Eutopic Endometrium ◽

Stromal Component ◽

Hotspot Mutations

AbstractRecent studies have reported cancer-associated mutations in normal endometrium. Mutations in eutopic endometrium may lead to endometriosis and endometriosis-associated ovarian cancer. We investigated PIK3CA mutations (PIK3CAm) for three hotspots (E542K, E545K, H1047R) in eutopic endometrium in patients with ovarian cancer and endometriosis from formalin-fixed paraffin-embedded specimens by laser-capture microdissection and droplet digital PCR. The presence of PIK3CAm in eutopic endometrial glands with mutant allele frequency ≥ 15% were as follows: ovarian clear cell carcinoma (OCCC) with PIK3CAm in tumors, 20/300 hotspots in 11/14 cases; OCCC without PIK3CAm, 42/78 hotspots in 11/12 cases; high-grade serous ovarian carcinoma, 8/45 hotspots in 3/5 cases; and endometriotic cysts, 5/63 hotspots in 5/6 cases. These rates were more frequent than in noncancer nonendometriosis controls (7/309 hotspots in 5/17 cases). In OCCC without PIK3CAm, 7/12 (58%) cases showed multiple hotspot mutations in the same eutopic endometrial glands. In 3/54 (5.6%) cases, PIK3CAm was found in eutopic endometrial stroma. Multisampling of the OCCC tumors with PIK3CAm showed intratumor heterogeneity in three of eight cases. In two cases, PIK3CAm was detected in the stromal component of the tumor. Homogenous PIK3CAm in the epithelial component of the tumor matched the mutation in eutopic endometrial glands in only one case. Eutopic endometrial glands in ovarian cancer and endometriosis show high frequency of PIK3CAm that is not consistent with tumors, and multiple hotspot mutations are often found in the same glands. While the mutations identified in eutopic endometrium may not be driver mutations in the patient’s cancer, these are still driver mutations but this specific clone has not undergone the requisite steps for the development of cancer.

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