title: Prognostic determinants in patients with uterine and ovarian clear cell carcinoma: a SEER analysis.
abstract: BACKGROUND
  The purpose of this study is to analyze and compare the demographics, treatment, and survival rates in patients with uterine clear cell carcinoma (UCCC) and ovarian clear cell carcinoma (OCCC).
  
  
  METHODS
  The Surveillance, Epidemiology and End Results (SEER) program data for all 18 registries from 1988 to 2010 was reviewed to identify women with OCCC and UCCC. Demographic and clinical data were compared, and the impact of tumor site on survival was analyzed using the Kaplan-Meier method. Factors predictive of outcome were compared using the Cox proportional hazards model.
  
  
  RESULTS
  The final study group consisted of 5421 women with clear cell histopathology. 3631 (67%) had OCCC and 1790 (33%) had UCCC. The mean age at diagnosis was 56 (± 12) years for women with OCCC and 67.7 (± 12.0) years for UCCC (P<0.001). Patients with OCCC had a higher rate of late stage disease (38.9% vs. 21.2%; P<0.001). Over the entire study period, after adjusting for known variables, there was no significant difference in cancer specific mortality between UCCC and OCCC, HR 1.05 (0.92-1.19). In the subset analysis by staging, in women with localized disease there was an improved survival in UCCC compared to OCCC. In contrast, in women with distant disease there was an increased mortality in women with UCCC.
  
  
  CONCLUSIONS
  In the entire population, there was no significant difference in cancer related mortality between the groups. However, in women with localized disease, UCCC had improved survival, but increased mortality in distant disease compared to OCCC.
authors.affiliation: Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: J Alejandro
authors.initials: JA
authors.lastname: Rauh-Hain
authors.forename: Michelle
authors.initials: M
authors.lastname: Davis
authors.forename: Joel
authors.initials: J
authors.lastname: Clemmer
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Clark
authors.forename: Whitfield B
authors.initials: WB
authors.lastname: Growdon
authors.forename: A K
authors.initials: AK
authors.lastname: Goodman
authors.forename: David M
authors.initials: DM
authors.lastname: Boruta
authors.forename: John O
authors.initials: JO
authors.lastname: Schorge
authors.forename: Marcela G
authors.initials: MG
authors.lastname: del Carmen
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy
keywords: Ovarian clear cell carcinoma; Uterine clear cell carcinoma