title: Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease.
abstract: 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.
authors.affiliation: Vincent Memorial Gynecologic Oncology Division, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Goff
authors.forename: R
authors.initials: R
authors.lastname: Sainz de la Cuesta
authors.forename: H G
authors.initials: HG
authors.lastname: Muntz
authors.forename: D
authors.initials: D
authors.lastname: Fleischhacker
authors.forename: M
authors.initials: M
authors.lastname: Ek
authors.forename: L W
authors.initials: LW
authors.lastname: Rice
authors.forename: N
authors.initials: N
authors.lastname: Nikrui
authors.forename: H K
authors.initials: HK
authors.lastname: Tamimi
authors.forename: J M
authors.initials: JM
authors.lastname: Cain
authors.forename: B E
authors.initials: BE
authors.lastname: Greer
authors.forename: A F
authors.initials: AF
authors.lastname: Fuller
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D002945:Cisplatin