Goff B A, Sainz de la Cuesta R, Muntz H G, Fleischhacker D, Ek M, Rice L W, Nikrui N, Tamimi H K, Cain J M, Greer B E, Fuller A F
Vincent Memorial Gynecologic Oncology Division, Harvard Medical School, Boston, Massachusetts 02114, USA.
Gynecol Oncol. 1996 Mar;60(3):412-7. doi: 10.1006/gyno.1996.0065.
Between 1982 and 1992, 24 women with Stage III clear cell ovarian cancer were identified from the tumor registry. Thirty-four women with Stage III papillary serous tumors treated between 1987 and 1989 were used as a comparison. All patients underwent cytoreductive surgery followed by conventional platinum-based chemotherapy. In the women with clear cell histology, nine (37.5%) had endometriosis in the surgical specimen compared with one (3%) in the papillary serous group (P = 0.002). Ten women (42%) with clear cell histology experienced a thromboembolic event during the course of treatment, compared to six (18%) in the papillary serous group (P = 0.05). In the group with clear cell histology, overall, 70% of women had progressive disease. Fifty-two percent experienced clinical progression while receiving platinum-based chemotherapy. In addition, four patients were found to have progressive disease at second-look laparotomy. Only two patients had a pathologic complete response. In the group with papillary serous histology, 29% overall had progressive disease while on chemotherapy (P = 0.005). The median survival for the women with clear cell histology was 12 months compared to 22 months for those with papillary serous (P = 0.02). For women with clear cell histology, univariate analysis was used to evaluate prognostic factors. Age less than 50 was a poor prognostic factor (P = 0.045). The presence of endometriosis, thromboembolic event, or optimal cytoreduction were not prognostic factors (P = 0.67, P = 0.34, P = 0.39). Patients with advanced clear cell ovarian cancer have a poor response to conventional platinum-based chemotherapy and overall prognosis is poor.
1982年至1992年间，从肿瘤登记处识别出24例III期透明细胞卵巢癌女性患者。选取1987年至1989年间接受治疗的34例III期乳头状浆液性肿瘤女性患者作为对照。所有患者均接受了肿瘤细胞减灭术，随后进行传统的铂类化疗。在透明细胞组织学类型的女性患者中，手术标本中有9例（37.5%）存在子宫内膜异位症，而乳头状浆液性组为1例（3%）（P = 0.002）。透明细胞组织学类型的10例女性患者（42%）在治疗过程中发生了血栓栓塞事件，乳头状浆液性组为6例（18%）（P = 0.05）。总体而言，透明细胞组织学类型组中70%的女性疾病进展。52%的患者在接受铂类化疗时出现临床进展。此外，4例患者在二次剖腹探查时发现疾病进展。只有2例患者达到病理完全缓解。在乳头状浆液性组织学类型组中，总体上29%的患者在化疗期间疾病进展（P = 0.005）。透明细胞组织学类型女性患者的中位生存期为12个月，而乳头状浆液性患者为22个月（P = 0.02）。对于透明细胞组织学类型的女性患者，采用单因素分析评估预后因素。年龄小于50岁是不良预后因素（P = 0.045）。子宫内膜异位症、血栓栓塞事件或最佳肿瘤细胞减灭术的存在不是预后因素（P = 0.67、P = 0.34、P = 0.39）。晚期透明细胞卵巢癌患者对传统铂类化疗反应不佳，总体预后较差。
