Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900 Monza, Italy; Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, Italy.
Department of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900 Monza, Italy; Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, Italy.
Gynecol Oncol. 2021 Jan;160(1):64-70. doi: 10.1016/j.ygyno.2020.10.014. Epub 2020 Oct 17.
advanced stage clear cell ovarian cancer (CCOC) carries a higher risk of relapse and death compared to other histological subtypes. The prognosis of early-stage CCOC is controversial.
Early-stage high-grade OC patients from two Italian oncologic centers were included. Patients with early-stage CCOC were compared with those with high-grade endometrioid (HGE) and serous (HGS) OC in terms of relapse-free interval (RFI), cancer-specific survival (CSS) and post relapse cancer-specific survival (prCSS). The Cox proportional hazard model and the restricted mean survival time were used.
Between 1981 and 2012, 134 patients with CC, 152 with HGE and 160 with HGS were treated at two referral centers. Median follow-up was 11.5 years. Ten years RFI rates were 80.6%, 72.1%, 60.6%, and CSS rates were 84.3%, 82.6%, 81.7% respectively. Adjuvant chemotherapy significantly improved RFI (aHR 0.61, 95%CI 0.40 to 0.91, P = 0.015). In the multivariable analysis HGS histotype was associated with a shorter RFI compared to CC, (Hazard Ratio [HR]: 1.81; 95%CI: 1.12-2.93; P = 0.016), whereas CSS was not statistically different. prCSS was longer in HGS compared to CCOC (HR, 0.36; 95% CI, 0.17-0.74; P = 0.006). According to the stage, IA/IB/IC1 HGSOC had a shorter RFI (HR, 2.13; 95% CI, 1.14-3.99; P = 0.018) compared to IA/IB/IC1 CCOC, but similar CSS. For prCSS, CC compared to HGS conferred a worse prognosis regardless of the initial stage.
Early-stage CCOC is associated with a longer RFI, similar CSS and a shorter prCSS compared to HGSOC. No prognostic differences were observed between CC and HGE OC. The relapse risk was the lowest in IA/IB/IC1 CC compared to HGS, whereas CC displayed poor sensitivity to chemotherapy after relapse.
与其他组织学亚型相比，晚期透明细胞卵巢癌（CCOC）复发和死亡的风险更高。早期 CCOC 的预后存在争议。
纳入来自意大利两家肿瘤中心的早期高级别卵巢癌患者。比较早期 CCOC 患者与高级别子宫内膜样（HGE）和高级别浆液性（HGS）卵巢癌患者的无复发生存期（RFI）、癌症特异性生存率（CSS）和复发后癌症特异性生存率（prCSS）。采用Cox 比例风险模型和限制平均生存时间。
1981 年至 2012 年间，在两个转诊中心治疗了 134 例 CC、152 例 HGE 和 160 例 HGS 患者。中位随访时间为 11.5 年。10 年 RFI 率分别为 80.6%、72.1%、60.6%，CSS 率分别为 84.3%、82.6%、81.7%。辅助化疗显著改善了 RFI（aHR 0.61，95%CI 0.40-0.91，P=0.015）。在多变量分析中，与 CC 相比，HGS 组织学类型与较短的 RFI 相关（风险比 [HR]：1.81；95%CI：1.12-2.93；P=0.016），而 CSS 无统计学差异。与 CCOC 相比，HGS 的 prCSS 更长（HR，0.36；95%CI，0.17-0.74；P=0.006）。根据分期，IA/IB/IC1 HGSOC 的 RFI 较 IA/IB/IC1 CCOC 缩短（HR，2.13；95%CI，1.14-3.99；P=0.018），但 CSS 相似。对于 prCSS，CC 与 HGS 相比，无论初始分期如何，预后均较差。
与 HGSOC 相比，早期 CCOC 的 RFI 较长，CSS 相似，prCSS 较短。CC 和 HGE OC 之间未观察到预后差异。与 HGS 相比，IA/IB/IC1 CC 的复发风险最低，而 CC 对化疗的敏感性较差。
