title: Impact of surgical staging in stage I clear cell adenocarcinoma of the ovary.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of surgical staging in stage I clear cell adenocarcinoma of the ovary (CCC).
  
  
  METHODS
  We performed a retrospective review of 165 patients with stage I CCC treated with optimal or nonoptimal staging surgery.
  
  
  RESULTS
  The median follow-up period in this study was 67 months. No significant difference was detected in recurrence-free survival (RFS) or overall survival (OS) between patients optimally and nonoptimally staged (RFS: P = 0.434; OS: P = 0.759). The estimated 5-year RFS and OS rates were 92.1% and 95.3% in patients with stages IA/IC1 and 81.0% and 83.7% in stages IC2/IC3, respectively. The multivariate analysis indicated that stages IC2/IC3 predicted worse RFS and OS than stages IA/IC1 in stage I CCC patients (RFS: P = 0.011; OS: P = 0.011). Subsequently, we investigated the impact of surgical staging, respectively, in stages IA/IC1 and stages IC2/IC3. Significant differences were observed in PFS and OS between patients optimally and nonoptimally staged with stages IA/IC1 (RFS: P = 0.021; OS: P = 0.024), but no significant difference was found in those with stages IC2/IC3. The multivariate analysis indicated that nonoptimal staging surgery predicted worse RFS than the optimal staging surgery in stages IA/IC1 CCC patients (P = 0.033). In addition, we investigated the impact of surgical staging for stages IA/IC1 in the adjuvant chemotherapy group. The 5-year RFS and OS rates in patients optimally and nonoptimally staged with stages IA/IC1 in the adjuvant chemotherapy group were 97.8% and 100%, and 85.2% and 89.4%, respectively. The multivariate analysis indicated that nonoptimal staging surgery predicted worse RFS than the optimal staging surgery for stages IA/IC1 patients in the adjuvant chemotherapy group (P = 0.019).
  
  
  CONCLUSIONS
  The prognosis for women with stage 1A/IC1 is very good. Surgical staging category was the only independent prognostic factor for RFS in stages IA/IC1 CCC.
authors.affiliation: *Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, Kashiwa; and †Department of Obstetrics and Gynecology, The Jikei University School of Medicine; ‡Department of Obstetrics and Gynecology, The Jikei University Daisan Hospital; and §Department of Obstetrics and Gynecology, The Jikei University Katsushika Medical Center, Tokyo, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takakura
authors.forename: Motoaki
authors.initials: M
authors.lastname: Saito
authors.forename: Asuka
authors.initials: A
authors.lastname: Morikawa
authors.forename: Jiro
authors.initials: J
authors.lastname: Suzuki
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Takahashi
authors.forename: Chie
authors.initials: C
authors.lastname: Nagata
authors.forename: Nozomu
authors.initials: N
authors.lastname: Yanaihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanabe
authors.forename: Aikou
authors.initials: A
authors.lastname: Okamoto
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D003949:Diagnostic Techniques, Surgical; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017239:Paclitaxel; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000627:therapeutic use; D019772:Topotecan / Q000627:therapeutic use
chemical_list: D043823:Taxoids; D019772:Topotecan; D017239:Paclitaxel; D002945:Cisplatin