Behbakht K, Randall T C, Benjamin I, Morgan M A, King S, Rubin S C
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,The University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, 19104, USA.
Gynecol Oncol. 1998 Aug;70(2):255-8. doi: 10.1006/gyno.1998.5071.
The aim of this study is to evaluate the clinical characteristics of clear cell carcinoma of the ovary.
Between 1986 and 1996, 45 patients with clear cell carcinoma of the ovary were identified by scanning the medical records department and the tumor registry at our institution.
Median age was 55 years (range 31-80 years). Tumors were 60% (27/45) stage I, 11% (5/45) stage II, 20% (9/45) stage III, and 9% (4/45) stage IV. All patients presented with a pelvic mass ranging in size from 2 x 3 to 20 x 30 cm and all except 1 had optimal cytoreduction. All patients received postoperative platinum-based chemotherapy, 47% (21/45) in combination with paclitaxel. One stage Ia patient refused therapy. Of the 6 stage III/IV patients with measurable residual tumor, 67% (4/6) partially responded to first line chemotherapy by CT scan or second look laparotomy. Recurrences occurred in 37% (10/27) stage I patients, including 18% (2/11) stage Ia, 33% (1/3) stage Ib, and 54% (7/13) stage Ic. Time to recurrence was 16 and 38 months for the two stage Ia patients and 35 months (median, range 18-56 months) for the stage Ic patients. Survival after recurrence was significantly related to disease-free interval after primary chemotherapy. With a median follow-up of 40 months (range 4-145 months), 93% (25/27) of stage I patients are alive, 20% (5/25) with disease, while 46% (6/13) of stage III/IV patients are alive. Median survival for the stage III/IV patients was 22 months (range 4-70 months).
Clear cell tumors of ovary frequently present at early stages. However, these tumors have a propensity for recurrence even after primary chemotherapy in early stage tumors.
本研究旨在评估卵巢透明细胞癌的临床特征。
1986年至1996年间，通过查阅我院病历科和肿瘤登记处的资料，确定了45例卵巢透明细胞癌患者。
中位年龄为55岁（范围31 - 80岁）。肿瘤分期为Ⅰ期60%（27/45）、Ⅱ期11%（5/45）、Ⅲ期20%（9/45）、Ⅳ期9%（4/45）。所有患者均表现为盆腔包块，大小从2×3至20×30 cm不等，除1例患者外其余患者均接受了理想的肿瘤细胞减灭术。所有患者术后均接受了铂类化疗，47%（21/45）联合紫杉醇化疗。1例Ⅰa期患者拒绝治疗。在6例有可测量残留肿瘤的Ⅲ/Ⅳ期患者中，67%（4/6）通过CT扫描或二次剖腹探查对一线化疗部分缓解。Ⅰ期患者中37%（10/27）复发，其中Ⅰa期18%（2/11）、Ⅰb期33%（1/3）、Ⅰc期54%（7/13）。2例Ⅰa期患者复发时间分别为16个月和38个月，Ⅰc期患者复发时间为35个月（中位时间，范围18 - 56个月）。复发后的生存与初次化疗后的无病间期显著相关。中位随访40个月（范围4 - 145个月），Ⅰ期患者93%（25/27）存活，其中20%（5/25）有疾病，而Ⅲ/Ⅳ期患者46%（6/13）存活。Ⅲ/Ⅳ期患者的中位生存期为22个月（范围4 - 70个月）。
卵巢透明细胞肿瘤常为早期发病。然而，即使早期肿瘤在初次化疗后仍有复发倾向。
