title: Long-term clinical outcome of patients with recurrent epithelial ovarian carcinoma: is it the same for each histological type?
abstract: OBJECTIVE
  This study was conducted to estimate the long-term clinical outcome of patients with recurrent ovarian carcinoma (ROC).
  
  
  METHODS
  Six hundred three patients with ROC were analyzed in this study. The pathological slides were evaluated under central pathological review. The prognostic significances of clinicopathologic factors were evaluated using both univariate and multivariate analysis.
  
  
  RESULTS
  The 5-year overall survival (OS) and postrecurrence survival (PRS) rates were 31.1 and 16.9%, respectively. On stratifying to treatment periods, the PRS has been prolonged over the last decade (year ≥2000) compared with before this period (year ≤1999) (P = 0.0002). In contrast, on stratifying to histological types and treatment periods, in both OS and PRS, the prognosis of patients with the nonmucinous/clear-cell histology, including serous, endometrioid, and other histological types, was significantly improved after 2000 compared with before (year ≤1999) (OS, P = 0.0009; PRS, P < 0.0001). In contrast, that of patients with the mucinous/clear-cell histology did not significantly differ regardless of the treatment period (≥2000 vs ≤1999: OS, P = 0.3887; PRS, P = 0.7617). In multivariate analysis, the stage, period of starting initial treatment, histological type, and the treatment-free interval were independent prognostic factors of a poor OS and PRS (OS/PRS: histological type: mucinous/clear-cell vs nonmucinous/clear-cell: hazard ratio, 1.300/1.498; 95% confidence interval [CI], 1.039-1.626/1.197-1.874).
  
  
  CONCLUSIONS
  Despite the continuous administration of treatment for ROC, survival is poor, and the extent of therapeutic progress differs according to the histological type.
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. kajiyama@med.nagoya-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kajiyama
authors.forename: Kiyosumi
authors.initials: K
authors.lastname: Shibata
authors.forename: Mika
authors.initials: M
authors.lastname: Mizuno
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Umezu
authors.forename: Shiro
authors.initials: S
authors.lastname: Suzuki
authors.forename: Eiko
authors.initials: E
authors.lastname: Yamamoto
authors.forename: Sawako
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Michiyasu
authors.initials: M
authors.lastname: Kawai
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nagasaka
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult