title: Surgical and medical treatment of clear cell ovarian cancer: results from the multicenter Italian Trials in Ovarian Cancer (MITO) 9 retrospective study.
abstract: OBJECTIVE
  Clear cell ovarian carcinoma has a poorer prognosis compared with other histological subtypes.
  
  
  METHODS
  The Multicenter Italian Trials in Ovarian Cancer (MITO) 9 study retrospectively assessed an Italian cohort of patients with clear cell ovarian cancer observed in the years 1991-2007 in 20 Italian centers.
  
  
  RESULTS
  A total of 240 patients with ovarian cancer were analyzed. Forty-five percent of the patients had stage I disease. In 62.9%, clear cell histology was pure, whereas in the other cases, a mixed population was evident. Most of the cases underwent standard surgery, whereas in 7.1% of the patients, a fertility-sparing surgery was given. Lymphadenectomy was performed in 47.9% (115/240) of the patients (54.3% in stages I and II; 39.2% in advanced stage). Most of the patients were treated with platinum-based chemotherapy including paclitaxel in 52.9%. Disease-free survival was longer in patients undergoing lymphadenectomy at surgery (P = 0.0001), both in early stages (P = 0.0258) and in stage III and IV diseases (P = 0.0037). The impact of lymphadenectomy was also evident on overall survival in patients with advanced-stage disease. At multivariate analysis, lymphadenectomy (done vs not done) and stage (I and II vs III and IV) were independently associated with longer disease-free and overall survival, whereas front-line chemotherapy (with vs without taxanes) was not significant.
  
  
  CONCLUSIONS
  This analysis suggests that lymphadenectomy has a strong prognostic role for clear cell ovarian cancer influencing disease-free survival and overall survival. The addition of paclitaxel to platinum-based chemotherapy does not affect the outcome.
authors.affiliation: II Ginecologia e Ostetricia, Azienda Ospedaliera Policlinico, Bari, Italy.
authors.forename: Francescapaola
authors.initials: F
authors.lastname: Magazzino
authors.forename: Dionyssios
authors.initials: D
authors.lastname: Katsaros
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ottaiano
authors.forename: Angiolo
authors.initials: A
authors.lastname: Gadducci
authors.forename: Carmela
authors.initials: C
authors.lastname: Pisano
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorio
authors.forename: Emanuela
authors.initials: E
authors.lastname: Rabaiotti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.forename: Gennaro
authors.initials: G
authors.lastname: Cormio
authors.forename: Luca
authors.initials: L
authors.lastname: Scarampi
authors.forename: Stefano
authors.initials: S
authors.lastname: Greggi
authors.forename: Antonella
authors.initials: A
authors.lastname: Savarese
authors.forename: Marco
authors.initials: M
authors.lastname: Marinaccio
authors.forename: Paolo
authors.initials: P
authors.lastname: Scollo
authors.forename: Sandro
authors.initials: S
authors.lastname: Pignata
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome