Survival benefit for patients with advanced-stage transitional cell carcinomas vs. other subtypes of ovarian carcinoma after chemotherapy with platinum and paclitaxel.
OBJECTIVE
Transitional cell carcinoma (TCC) of the ovary is a less well recognized histological type of ovarian carcinoma resembling TCC of the urinary bladder. A better prognosis due to a better chemosensitivity of ovarian TCC has been suggested. It was the aim of the present retrospective study to compare incidence and outcome of patients with TCCs and other subtypes of ovarian carcinoma from a large homogeneous collective of patients with primary advanced-stage ovarian carcinoma.


METHODS
H and E-stained sections from a total of 302 cases from a prospective randomized, multi-center, phase III study of patients with ovarian cancer, FIGO-stages IIB-IV, comparing cisplatin plus paclitaxel (PT) with paclitaxel plus carboplatin (TC) were available for histological retyping of ovarian carcinomas applying current WHO criteria. Kaplan-Meier survival analysis was performed.


RESULTS
16 of 302 tumors (5.3%) were diagnosed as TCC. Only 1 of the 16 TCCs had been previously diagnosed as such by referring pathologists. TCCs were associated with smaller preoperative extraovarian tumor and with smaller postoperative residual tumor. 5-year survival of patients with TCC was 57% as compared to 31% for patients with ovarian carcinomas of other types (P = 0.03).


CONCLUSIONS
TCC of the ovary seems to be a less well recognized entity. In the current series, TCCs had a significantly better prognosis as compared to all other types of ovarian carcinomas after standardized chemotherapy. A propensity for micronodular rather than macronodular extraovarian spread and better surgical resectability of TCC might contribute to the survival benefit.
Kommoss
Friedrich
F
Institute of Pathology, A2, 2, 68159 Mannheim, Germany. kommoss@gyn-patho.de
Kommoss
Stefan
S
Schmidt
Dietmar
D
Trunk
Marcus J
MJ
Pfisterer
Jacobus
J
du Bois
Andreas
A
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies
D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin