The clinical characteristics and outcomes of cases with pure ovarian clear cell, mixed type and high-grade serous adenocarcinoma

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Pure ovarian clear cell, mixed type, and high-grade serous adenocarcinomas were compared by clinical characteristics and outcomes, finding distinct features and survival rates influenced solely by disease stage.

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This retrospective study compared clinical characteristics and survival outcomes among 32 cases of pure ovarian clear cell adenocarcinoma (OCCC), 23 cases of mixed ovarian adenocarcinoma (MOC; combinations including clear cell, serous, and/or endometrioid), and 28 cases of high-grade serous ovarian adenocarcinoma (HGSOC), using data collected between 1999 and 2011. Pure OCCC patients were younger and had lower median pre-operative CA-125 levels, whereas HGSOC showed higher frequencies of bilaterality and peritoneal carcinomatosis and was more often diagnosed at advanced stage; endometriosis was present in 29% of OCCC cases (16/55). Median survival did not differ significantly across histologic groups, and the disease stage was reported as the only important survival factor. This paper is centrally about adenocarcinoma histologic subtypes and explicitly includes endometriosis occurrence in OCCC, making it directly relevant to endometriosis-associated ovarian cancer patterns.

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Abstract

Purpose This study aimed to compare the clinical characteristics and outcomes of the cases with pure ovarian clear cell adenocarcinoma (OCCC), mixed type (clear plus serous or clear plus endometrioid or serous plus clear plus endometrioid) ovarian adenocarcinoma (MOC) and high-grade serous ovarian adenocarcinoma (HGSOC).

Methods

A retrospective comparison was conducted in 32 cases with pure OCCC, 23 cases with MOC and 28 cases with HGSOC followed between January 1999 and October 2011. Clinico-pathologic characteristics including histopathologic subtypes, age, stage, presence of ascites and/or peritoneal carcinomatosis, endometriosis and optimal cytoreduction, and also survival rates were compared in these three groups.

Results

The cases with pure OCCC were younger than the cases with MOC and HGSOC (p = 0.004). The median pre-operative CA-125 level was lower in the pure OCCC than in MOC and HGSOC (p = 0.006) (p = 0.001, p = <0.001, respectively). Bilaterality and peritoneal carcinomatosis were more frequently seen in the HGSOC group (p = 0.001, p < 0.001, respectively). The majority of the cases (65 %) had stage I or II disease in the pure OCCC group, but most of the cases in the HGSOC group had advanced stage disease (p < 0.001). Endometriosis was found in 16 cases (16/55, 29 %) in the OCCC group. No significant difference was detected with regard to the median survival rate among three groups (p = 0.517), while the stage of disease was found to be the only important factor for survival (p = 0.002).

Conclusion

Pure OCCC, MOC and HGSOC represent distinct clinical characteristics. Clinical characteristics of MOC are more similar to those of HGSOC. Similar content being viewed by others

References

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Arch Gynecol Obstet 292, 923–929 (2015). https://doi.org/10.1007/s00404-015-3699-9 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-015-3699-9

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Cystadenocarcinoma, Serous Gynecologic Surgical Procedures Neoplasms, Glandular and Epithelial Ovarian Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Age Distribution Antineoplastic Agents Antineoplastic Agents Carcinoma, Ovarian Epithelial Chemotherapy, Adjuvant Cystadenocarcinoma, Serous Cystadenocarcinoma, Serous Cystadenocarcinoma, Serous Cystadenocarcinoma, Serous Endometriosis

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