title: Oncologic outcome after recurrence in patients with stage I epithelial ovarian cancer: are clear-cell and mucinous histological types a different entities?
abstract: OBJECTIVE
  This study was conducted to estimate the oncologic outcome of stage I epithelial ovarian carcinoma (EOC) patients after recurrence.
  
  
  METHODS
  After central pathological review and searching of the medical records of multi-institutions, a total of 103 relapsed patients with stage I EOC were analyzed. The major endpoint was postrecurrence survival (PRS).
  
  
  RESULTS
  The median follow-up for surviving patients was 57.5 (5.7-242.0) months. The median age was 52 (14-89). Among the patients, 19 (18.4%) had FIGO IA disease, and 4 (3.9%) and 80 (77.7%) had IB and IC disease, respectively. Regarding the histological type, the clear-cell type was the most frequently observed (N=42: 40.8%). The 3/5-year overall and PRS rates of all patients were 63.7/47.9 and 38.2/24.0%, respectively. The 5-year PRS rates of patients with serous, endometrioid, clear-cell, and mucinous tumors were 44.9, 35.0, 19.8, and 0%, respectively. On stratifying by the histological type, the overall and postrecurrence survival rates of patients with the mucinous/clear-cell types were significantly poorer than in those with the non-mucinous/clear-cell types (OS: P=0.0253, PRS: P=0.0016). In multivariate analyses, the FIGO stage (IA/IB vs. IC) and histological type (clear-cell/mucinous vs. non- clear-cell/mucinous) retained their significance as prognostic factors of a poorer PRS {stage IC (vs.
  2.176 (95% CI: 1.059-4.470), P=0.0343: clear-cell/mucinous (vs. non- clear-cell/mucinous): HR: 2.486(95% CI: 1.416-4.364), P=0.0015).
  
  
  CONCLUSIONS
  Even if at stage I, once patients with a mucinous/clear-cell histology experience recurrence, subsequent survival is extremely poor.
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan. Electronic address: kajiyama@med.nagoya-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kajiyama
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Kiyosumi
authors.initials: K
authors.lastname: Shibata
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Umezu
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Eiko
authors.initials: E
authors.lastname: Yamamoto
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Mitsui
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Sekiya
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Niimi
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Michiyasu
authors.initials: M
authors.lastname: Kawai
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nagasaka
authors.affiliation: Nagoya University, Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology* / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000473:pathology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D010052:Ovariectomy; D011379:Prognosis; D058994:Salpingectomy; D015996:Survival Rate; D055815:Young Adult
keywords: Clear-cell carcinoma; Mucinous adenocarcinoma; Overall survival; Postrecurrence survival; Recurrent ovarian cancer; Stage I