Prognostic value of lymph nodes ratio in patients with stage III ovarian clear cell carcinoma: A retrospective study of patients in Southwest China

Abstract Background Ovarian clear cell carcinoma (OCCC) is a special pathological type of epithelial ovarian carcinoma (EOC), we conducted this research in order to investigate the clinical characteristics and outcomes of OCCC and to provide additional supporting evidence to aid in the clinical diagnosis and management. Methods This was a retrospective study investigating the clinical characteristics and survival outcomes of 87 patients with OCCC treated at our center between January 2010 and March 2020. Survival analysis was also performed on 179 patients with OCCC obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registry database. Results The median age of participants was 49.28 ± 9.8 years old, with 74.71% diagnosed at early stage. Median CA125 level was 607.26 IU/mL, with 23.94% having normal CA125 levels. 16 patients (18.39%) had co-existing endometriosis and 8 patients (9.2%) developed venous thromboembolism (VTE). There were 5 patients received suboptimal cytoreduction. 67 patients (77.01%) underwent lymphadenectomy, and only 3 (4.48%) were found to have positive lymph nodes. Patients diagnosed at an early stage had higher 3-year overall survival (OS) and progression-free survival (PFS) rates than those with advanced stage OCCC. CA199 (P = 0.025) and ascites (P = 0.001) were significantly associated with OS, while HE4 (P = 0.027) and ascites (P = 0.001) were significantly associated with PFS. Analysis of data from the SEER database showed that positive lymph nodes is also an independent prognostic factor for OS (P = 0.001). Conclusions OCCC often presents at an early stage and young age with a mildly elevated CA125. CA199, HE4, massive ascites and positive lymph node are independent prognostic factors.

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Clinical characteristics and prognosis of ovarian clear cell carcinoma: a 10-year retrospective study

BMC Cancer ◽

10.1186/s12885-021-08061-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chenchen Zhu ◽

Jing Zhu ◽

Lili Qian ◽

Hanyuan Liu ◽

Zhen Shen ◽

...

Keyword(s):

Retrospective Study ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Clinical Characteristics ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Supporting Evidence ◽

Ovarian Clear Cell Carcinoma ◽

Positive Lymph Nodes

Abstract Background Ovarian clear cell carcinoma (OCCC) is a special pathological type of epithelial ovarian carcinoma (EOC). We conducted this research to investigate the clinical characteristics and outcomes of OCCC and to provide additional supporting evidence to aid in the clinical diagnosis and management. Methods This was a retrospective study investigating the clinical characteristics and survival outcomes of 86 patients with OCCC treated at our center between January 2010 and March 2020. Survival analysis was also performed on 179 patients with OCCC obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registry database. Results The median age of participants was 49.21 ± 9.91 years old, and 74.42% of them were diagnosed at early stage. The median CA125 level was 601.48 IU/mL, while 19.77% of the patients had normal CA125 levels. Sixteen patients (18.60%) had co-existing endometriosis and 8 patients (9.3%) developed venous thromboembolism (VTE). There were 5 patients received suboptimal cytoreduction. Sixty-six patients (76.74%) underwent lymphadenectomy, and only 3 (4.55%) patients had positive lymph nodes. Patients diagnosed at an early stage had higher 3-year overall survival (OS) and progression-free survival (PFS) rates than those with advanced stage OCCC. CA19–9 (P = 0.025) and ascites (P = 0.001) were significantly associated with OS, while HE4 (P = 0.027) and ascites (P = 0.001) were significantly associated with PFS. Analysis of data from the SEER database showed that positive lymph nodes is also an independent prognostic factor for OS (P = 0.001). Conclusions OCCC often presents at an early stage and young age with a mildly elevated CA125. CA19–9, HE4, massive ascites, and positive lymph node are independent prognostic factors.

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Age and Lymph Nodes Examination May Be Related to the Outcome of Ovarian Clear Cell Carcinoma: A SEER Analysis

10.21203/rs.3.rs-864590/v1 ◽

2021 ◽

Author(s):

Menghan Zhu ◽

Nan Jia ◽

Wei Jiang

Keyword(s):

Lymph Nodes ◽

Cell Carcinoma ◽

Proportional Hazards ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Cox Proportional Hazards ◽

Stage I ◽

Stage Iii ◽

Ovarian Clear Cell Carcinoma ◽

Significant Difference

Abstract AimTo analyze and compare the demographics, treatment, and survival rates in patients with ovarian clear cell carcinoma (OCCC).MethodsWe conducted a population-based retrospective study examining the Surveillance, Epidemiology, and End Results Program from 1998 to 2016. Data of 4344 women with OCCC were compared, and survival was analyzed using the Kaplan–Meier method. Factors predictive of outcome were compared using the Cox proportional hazards model.ResultsThere was no significant difference in cause specific survival (CSS) regardless of chemotherapy in stage I and stage II OCCC. In women with stage III/IV OCCC, there was an increased mortality in women without chemotherapy (5-year CSS 29.80% vs. 24.90%, p<0.001). Among stage I women younger than 60 years old, the 5-year CSS of those underwent chemotherapy was worse than that of non-chemotherapy (86.4% vs. 97.50%, p=0.002). Among these patients, omitting chemotherapy had improved CSS (HR 0.539; 95% CI 0.386-0.753), and omitting lymph nodes examination had decreased CSS (HR 1.666; 95% CI 1.230-2.256). In stage III/IV women who were 60 years or older, the 5-year CSS of those underwent chemotherapy was better than that of non-chemotherapy (32.60% vs. 24.30%, p<0.001). Among these patients, omitting chemotherapy (HR 1.769; 95% CI 1.385-2.258) and omitting lymph nodes examination (HR 1.709; 95% CI 1.371-2.130) had lower CSS.ConclusionChemotherapy has different effects in patients with OCCC at different stages and ages. Age and lymph nodes examination may be factors that affect the outcome of patients with OCCC.

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Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: a Retrospective Study of 112 Patients in Beijing

10.21203/rs.3.rs-132769/v1 ◽

2020 ◽

Author(s):

Huimei Zhou ◽

Qian Liu ◽

Xiaohua Shi ◽

Jiaxin Yang ◽

Dongyan Cao ◽

...

Keyword(s):

Retrospective Study ◽

Cell Carcinoma ◽

Clinical Characteristics ◽

Cox Regression ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Stage I ◽

Stage Iii ◽

Ca 125 ◽

Ovarian Clear Cell Carcinoma

Abstract ObjectivesThis retrospective study aimed to evaluate the clinical characteristics and prognosis of ovarian clear cell carcinoma (OCCC) and to further explore the monitoring value of cancer antigen 125 (CA-125).MethodsThe medical records of 112 OCCC patients who were treated in Peking Union Medical College Hospital (PUMCH) between 2014 and 2019 were collected and reviewed, and data such as age, Federation of Gynecology and Obstetrics (FIGO) stage, CA-125 level, treatment, recurrence, and death were extracted.OutcomesThe median patient age was 50 (45, 57) years. Sixty (53.57%) patients were in stage I, 13 (11.61%) patients were in stage II, 22 (28.57%) patients were in stage III, and 7 (6.25%) patients were in stage IV. In total, 109 (97.32%) patients received adjuvant chemotherapy. The median chemotherapy cycles of CA-125 normalization was 2 (0, 3). The 1-year and 3-year progression-free survival (PFS) rates were 87.85% and 72.90%, respectively. The median PFS1 duration was 19 (11, 35) months, and the median overall survival (OS) duration was 24 (13, 40) months. Recurrence occurred in 32 patients, of whom 7 (21.88%) developed platinum-resistant recurrence. Fifty percent of relapsed patients had a CA-125 level<35 IU/ml at the time of relapse. Nine (28.13%) patients experienced a second recurrence. In the multivariate Cox regression analysis, the Chemotherapy cycles of CA-125 normalization remained nonsignificant for stage I (P=0.003, HR 4.287, 95% CI=1.632–11.258) and stage III (P=0.003, HR 4.287, 95% CI=1.632–11.258) disease. Multivariate Cox regression showed that platinum resistance was an independent factor for PFS2 (P=0.008, HR 11.562, 95% CI=1.873–71.353).ConclusionsFIGO stage and chemotherapy resistance are independent risk factors for prognosis. CA-125 levels following treatment are a valid indicator for treatment monitoring. Regardless of chemosensitivity to CA-125, CA-125 normalization before chemotherapy cycle 2 may not be a distinct inflection point for PFS and OS.

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