Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Cancer Res Treat. 2020 Jan;52(1):277-283. doi: 10.4143/crt.2019.292. Epub 2019 Jul 12.
The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in early stage.
Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected.
Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence.
Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.
本研究旨在评估韩国卵巢透明细胞癌（OCCC）的临床特征和治疗模式，以及辅助化疗在早期的作用。
回顾了 21 家机构的 308 例病历，收集了年龄、体能状态、子宫内膜异位症、血栓栓塞、分期、癌抗原 125、治疗、复发和死亡等数据。
OCCC 的分期为Ⅰ期 194 例（63.6%）、Ⅱ期 34 例（11.1%）、Ⅲ期 66 例（21.6%）和Ⅳ期 11 例（3.6%）。所有患者均接受了手术。89.3%的患者达到了最佳手术（残余肿瘤≤1cm）。大多数患者（80.5%）接受了术后化疗。最常见的方案是紫杉烷-铂类联合化疗（96%）。Ⅰ期患者的中位无复发生存期（RFS）为 138.5 个月，Ⅱ期为 33.4 个月，Ⅲ期为 19.3 个月，Ⅳ期为 9.7 个月。中位总生存期（OS）未达到，Ⅰ、Ⅱ、Ⅲ和Ⅳ期分别为 112.4、48.7、18.3 个月。早期（Ⅰ期）、子宫内膜异位症和最佳肿瘤减灭术是 RFS 的有利预后因素。早期和最佳肿瘤减灭术也是 OS 的有利预后因素。大多数早期患者接受了辅助化疗。然而，在复发方面并没有发现额外的生存获益。
大多数患者为早期，无论分期如何，均接受了术后化疗。早期和最佳肿瘤减灭术是有利的预后因素。在ⅠA 期或ⅠB 期，添加辅助化疗在生存方面没有差异。需要进一步研究 OCCC。
