scholarly journals Adjuvant Treatment of Early Ovarian Clear Cell Carcinoma: A Population-Based Study of Whole Abdominal Versus Pelvic Nodal Radiotherapy

2021 ◽  
Vol 19 (2) ◽  
pp. 172-180
Author(s):  
Soumyajit Roy ◽  
Paul Hoskins ◽  
Anna Tinker ◽  
Harinder Brar ◽  
Gale Bowering ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Adjuvant Treatment ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Final Analysis ◽  
Population Based ◽  
Ovarian Clear Cell Carcinoma ◽  
Population Based Study ◽  
Significant Difference

Background: Adjuvant treatment in early ovarian clear cell carcinoma (OCCC) is not yet standardized. The objective of this population-based study was to compare the outcome of patients with early OCCC treated with adjuvant chemotherapy versus chemoradiotherapy (chemoRT) and evaluate the association of adjuvant radiotherapy regimens (whole abdominal radiotherapy [WART] versus pelvic nodal radiotherapy [PRT]) with outcome. Patients and Methods: Chart review was conducted to identify patients with stage I and II OCCC with complete information on staging. Patients with stage IA, IB, or IC OCCC purely resulting from capsular rupture were excluded because the provincial protocol does not recommend adjuvant treatment. Results: Overall, 403 patients were identified and 343 received adjuvant treatment, of whom 255 had stage IC or II OCCC and 153 were eligible for final analysis. On Cox multivariable regression, receipt of chemoRT (n=90) was associated with an improvement in failure-free survival (FFS) (hazard ratio [HR], 0.57; 95% CI, 0.34–0.94) compared with chemotherapy alone (n=63). Use of chemoRT also resulted in 54% reduction in the cumulative incidence of cancer-specific mortality (subdistribution HR, 0.46; 95% CI, 0.24–0.89). However, there was no significant difference in the HR for overall survival (OS) between the chemoRT (HR, 0.70; 95% CI, 0.43–1.13) and chemotherapy group. Relative to chemotherapy + WART (chemo-WART), chemotherapy + PRT (chemo-PRT) was not associated with any significant difference in HR for FFS (HR, 1.34; 95% CI, 0.40–4.44) or OS (HR, 1.13; 95% CI, 0.37–3.46). Conclusions: Adjuvant chemoRT was associated with a lower risk of failure compared with chemotherapy alone. However, there was no difference in OS between the adjuvant chemotherapy and chemoRT regimens. Additionally, no significant difference in terms of FFS or OS was found between the chemo-WART and chemo-PRT groups.

A North American population-based outcome for early-stage ovarian clear cell carcinoma (OCCC).

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 5062-5062
Author(s):  
P. Hoskins ◽  
J. S. Albarrak ◽  
N. Le ◽  
A. Tinker ◽  
K. Swenerton ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
North American ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Early Stage ◽  
Population Based ◽  
North American Population ◽  
American Population ◽  
Ovarian Clear Cell Carcinoma

Adjuvant Chemotherapy for Stage I Ovarian Clear Cell Carcinoma: Is it Necessary for Stage IA?

2012 ◽  
Vol 22 (7) ◽  
pp. 1143-1149 ◽  
Author(s):  
Mika Mizuno ◽  
Hiroaki Kajiyama ◽  
Kiyosumi Shibata ◽  
Kimio Mizuno ◽  
Osamu Yamamuro ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Stage I ◽  
Surgical Staging ◽  
Recurrence Free Survival ◽  
Ovarian Clear Cell Carcinoma ◽  
Free Survival ◽  
Stage Ia

BackgroundIt is controversial whether patients with stage I ovarian clear cell carcinoma (CCC) benefit from postoperative chemotherapy. This study was designed to evaluate the postoperative outcomes associated with the inclusion or exclusion of adjuvant therapy in these patients.MethodsA total of 185 patients who were treated for stage I CCC between 1991 and 2007 were retrospectively evaluated. All of the patients had received comprehensive surgical staging, and their condition had been diagnosed by a central pathological review system. Only one patient with stage IB was excluded from this study.ResultsMedian follow-up time was 62 months (range 7–191 months). Median age was 52 years (30–75 years). There were 41, 93, and 50 patients in stage IA, intraoperative capsule ruptured IC (rupture-IC), and all other-IC groups, respectively. The 5-year recurrence-free survival rates for the substage were 97.6%, 87.8%, and 70.4% (P < 0.001), respectively. Among 134 patients consisting of those in the stage IA and rupture-IC groups, 91 patients received adjuvant chemotherapy (AC) and 43 patients did not (non-AC). There was no significant survival difference in each substage group between the non-AC and AC groups in 5-year recurrence-free survival rate (stage IA, 100% vs 93.8%; rupture-IC, 94.1% vs 86.6%). Multivariate analysis demonstrated that there was no significant prognostic factor for both recurrence and survival among the IA and rupture-IC groups. Postoperative therapy, regimen, and chemotherapy cycles were not significantly affected.ConclusionsThis study indicates that adjuvant chemotherapy does not contribute to the improving prognosis of stage IA ovarian CCC. Whereas the histological type is CCC, the routine adjuvant chemotherapy after comprehensive surgical staging may be unnecessary for patients with at least stage IA.

Reappraising hyalinizing clear cell carcinoma: A population‐based study with molecular confirmation

Head & Neck ◽  
2016 ◽  
Vol 39 (3) ◽  
pp. 503-511 ◽  
Author(s):  
Juan C. Hernandez–Prera ◽  
Ricky Kwan ◽  
Joseph Tripodi ◽  
Simion Chiosea ◽  
Carlos Cordon–Cardo ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Population Based ◽  
Population Based Study ◽  
Hyalinizing Clear Cell Carcinoma

Adjuvant chemotherapy for stage I ovarian clear cell carcinoma: Patterns of use and outcomes

2018 ◽  
Vol 150 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Dimitrios Nasioudis ◽  
Spyridon A. Mastroyannis ◽  
Benjamin B. Albright ◽  
Ashley F. Haggerty ◽  
Emily M. Ko ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Stage I ◽  
Ovarian Clear Cell Carcinoma ◽  
Patterns Of Use

Is adjuvant chemotherapy beneficial for surgical stage I ovarian clear cell carcinoma?

2017 ◽  
Vol 147 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Liat Hogen ◽  
Harry Brar ◽  
Allan Covens ◽  
Dina Bassiouny ◽  
Marcus Q. Bernardini ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Stage I ◽  
Ovarian Clear Cell Carcinoma

Low-Stage Ovarian Clear Cell Carcinoma: Population-Based Outcomes in British Columbia, Canada, With Evidence for a Survival Benefit As a Result of Irradiation

2012 ◽  
Vol 30 (14) ◽  
pp. 1656-1662 ◽  
Author(s):  
Paul J. Hoskins ◽  
Nhu Le ◽  
Blake Gilks ◽  
Anna Tinker ◽  
Jennifer Santos ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Relapse Rate ◽  
Survival Benefit ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Population Based ◽  
North American Population ◽  
American Population ◽  
Ovarian Clear Cell Carcinoma ◽  
Stage Ia

Purpose To evaluate the population-based outcomes of stage I and II ovarian clear cell carcinoma (OCCC) in a North American population treated with carboplatin/paclitaxel and abdominopelvic irradiation. Patients and Methods Retrospective analysis was performed of 241 patients referred in the carboplatin/paclitaxel era. Irradiation was to be used with a few defined exceptions. However, because of differing beliefs as to its effectiveness, its use was consistently avoided by specific oncologists, allowing the opportunity to study its possible effect on disease-free survival (DFS) in these concurrent cohorts. Results Five- and 10-year DFS rates were 84% and 70% for stage IA/B; 67% and 57% for stage IC; and 49% and 44% for stage II, respectively. Five- and 10-year DFS rates for those with stage IC disease based purely on rupture were similar to rates for patients with stage IA/B, at 92% and 71%, respectively. The remaining patients with stage IC had 48% 5- and 10-year DFS. Multivariate analysis using a decision tree identified positive cytology as the most important factor (72% relapse rate if positive and 27% if negative or unknown). If, in addition, the capsule surface was involved, then the relapse rate was 93%. Irradiation had no discernible survival benefit for patients with stage IA and IC (rupture alone), whereas for the remainder of patients with stage IC and stage II, it improved DFS by 20% at 5 years (relative risk, 0.5); the benefit was most evident in the cytologically negative/unknown group. Conclusion DFS is similar in this North American population with early OCCC to the DFS reported in Asia. A potential benefit from irradiation was evident in a subset.

scholarly journals Effect of Chemotherapy, Laparoscopy, and Cytology on Stage IC Ovarian Clear Cell Carcinoma: A Long-Term, Single-Center Study

2020 ◽  
Vol 17 (2) ◽  
pp. 491 ◽  
Author(s):  
Hao-Ting Chang ◽  
Mei-Ling Chiu ◽  
Tao-Yuean Wang ◽  
Tzu-Chien Chen ◽  
Chih-Long Chang ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Adjuvant Chemotherapy ◽  
Minimally Invasive ◽  
Cell Carcinoma ◽  
Invasive Surgery ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Progression Free Survival ◽  
Ovarian Clear Cell Carcinoma ◽  
Surgical Methods

Ovarian clear cell carcinoma (OCCC) is the second common histology of epithelial ovarian cancer in Taiwan. Stage IC is common, especially during minimally invasive surgery. Adjuvant chemotherapy in stage IC OCCC is unavoidable, and paclitaxel-based chemotherapy in Taiwan is self-paid. However, surgical spillage from minimally invasive surgery as a cause of unfavorable prognosis is still uncertain. The information of patients with stage IC OCCC, corresponding to a period of January 1995 to December 2016, was retrospectively collected following a chart and pathology review. Data regarding surgical methods, cytology status, regimens of adjuvant chemotherapy, survivorship, progression-free survival (PFS), and overall survival (OS) period were analyzed. In total, 88 patients were analyzed, and 64 and 24 patients were treated with paclitaxel- and nonpaclitaxel-based chemotherapy, respectively. Recurrence was identical between the two groups: PFS (47.5 ± 41.36 versus 54.0 ± 53.9 months, p = 0.157) and OS (53.5 ± 38.14 versus 79.0 ± 49.42 months, p = 0.070). Of the 88 patients, 12 had undergone laparoscopy for histological confirmation before complete open staging surgery; however, their PFS (49.5 ± 46.84 versus 49.0 ± 35.55 months, p = 0.719) and OS (56.5 ± 43.4 versus 51.0 ± 32.77 months, p = 0.600) were still comparable. Cytology results were only available for 51 patients, and positive washing cytology results seemed to worsen PFS (p = 0.026) but not OS (p = 0.446). In conclusion, adjuvant nonpaclitaxel chemotherapy and laparoscopic tumor spillage before the staging operation did not worsen the outcome in stage IC OCCC. Positive washing cytology has a negative effect on PFS but not on OS.

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