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

Chenchen Zhu, Jing Zhu, Lili Qian, Hanyuan Liu, Zhen Shen, Dabao Wu, Weidong Zhao, Weihua Xiao, Ying Zhou
BMC cancer · 2021 · vol. 21(1) , pp. 322 · doi:10.1186/s12885-021-08061-7 · PMID:33766002 · W3136330220
article OA: gold CC0 ⤵ 4 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study found that ovarian clear cell carcinoma often presents early with mild CA125 elevation, and that CA19-9, HE4, ascites, and positive lymph nodes are independent prognostic factors.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This 10-year retrospective study analyzed clinical characteristics and survival outcomes in 86 women with primary ovarian clear cell carcinoma (OCCC) treated at a single center (2010–2020), and additionally performed survival analysis on 179 OCCC patients from the SEER registry. The authors found that OCCC patients were typically younger and diagnosed at early stage, with CA125 often only mildly elevated (including a subgroup with normal CA125), and that endometriosis co-existed in 18.6% of cases; in their cohort, CA19-9 and ascites were associated with overall survival, while HE4 and ascites were associated with progression-free survival, and positive lymph nodes were also an independent prognostic factor in SEER. The major caveats are that the study is retrospective and single-center (and SEER analysis relies on registry data), with some excluded cases due to missing information, and survival collected up to a fixed date. This paper centrally about ovarian clear cell carcinoma includes explicit data on co-existing endometriosis, providing relevance to endometriosis through its reported prevalence and framing of endometriosis as a precancerous lesion of OCCC.

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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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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Carcinoma, Ovarian Epithelial Ovarian Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Biomarkers, Tumor Biomarkers, Tumor Carcinoma, Ovarian Epithelial Carcinoma, Ovarian Epithelial Carcinoma, Ovarian Epithelial Carcinoma, Ovarian Epithelial Cytoreduction Surgical Procedures Cytoreduction Surgical Procedures Female Humans Hysterectomy Hysterectomy

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