Clinico-pathologic and prognostic factor analysis on 121 cases of ovarian clear cell adenocarcinoma

Objective To investigate the clinical characteristics and prognostic factors in the patients with ovarian clear cell adenocarcinoma(OCCA).Methods Medical records of 121 patients with OCCA treated in our hospital from February 1999 to September 2009 were analyzed retrospectively.Results Median age at diagnosis was 48 years(range 24-73 years).The tumors were 57.0%(69/121)stage I,9.9%(12/121)stage Ⅱ,30.6%(37/121)stage Ⅲ,and 2.6%(3/121)stage Ⅳ.Five-year overall survival rate was 49.8%;68.7% in stage I,76.4% in stage Ⅱ,13.9% in stage Ⅲ and 0 in stage Ⅳ.There were 22(22/121,18.2%)patients with endometriosis.The recurrence rate was 41.7%(40/96).The response rate of residual tumor to chemotherapy was 44.4%(8/18).FIGO staging,lymphadenectomy,residual tumor diameter,peritoneal cytological status,sufficient chemotherapeutic cycles and progression free interval(PFI)were prognostic factors in patients with OCCA.CA125 expression levels before therapy or after 3-cycles of chemotherapy also were prognostic factors.Age of patients at diagnosis,endometriosis,histological type,tumor diameter and differences of chemotherapy regimes were not prognostic factors.Multivariate analysis revealed that PFI was significantly correlated with prognosis of OCCA(RR=0.289,P=0.002).Conclusion OCCA patients are often of early stage at diagnosis,with poor prognosis,easy recurrence,apt to be combined with endometriosis and low response to chemotherapy.Our results suggest that optimal cytoreductive surgery and sufficient postoperative chemotherapy can improve the prognosis of patients with OCCA.PFI is an independent prognostic factor for survival of OCCA patients.