Impact of Surgical Staging in Stage I Clear Cell Adenocarcinoma of the Ovary

• Published in: International journal of gynecological cancer Vol. 24; no. 7; pp. 1181 - 1189
• Main Authors: Suzuki, Kayo, Takakura, Satoshi, Saito, Motoaki, Morikawa, Asuka, Suzuki, Jiro, Takahashi, Kazuaki, Nagata, Chie, Yanaihara, Nozomu, Tanabe, Hiroshi, Okamoto, Aikou
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014; by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology; Elsevier Limited
• Subjects: Adenocarcinoma, Clear Cell - drug therapy; Adenocarcinoma, Clear Cell - mortality; Adenocarcinoma, Clear Cell - pathology; Adenocarcinoma, Clear Cell - surgery; Adjuvant chemotherapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer; Chemotherapy; Chemotherapy, Adjuvant; Cisplatin - therapeutic use; Clear cell carcinoma; Diagnostic Techniques, Surgical; Female; Humans; Lymph Node Excision; Lymphadenectomy; Lymphatic Metastasis; Medical prognosis; Middle Aged; Multivariate analysis; Neoplasm Staging; Ovarian cancer; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Ovaries; Paclitaxel; Retrospective Studies; Surgery; Surgical staging; Survival Analysis; Taxoids - therapeutic use; Topotecan - therapeutic use; Lymphadenectomy; Clear cell carcinoma; Adjuvant chemotherapy; Surgical staging; Ovarian cancer
• ISSN: 1048-891X; 1525-1438; 1525-1438
• DOI: 10.1097/IGC.0000000000000178

The aim of this study was to evaluate the impact of surgical staging in stage I clear cell adenocarcinoma of the ovary (CCC). We performed a retrospective review of 165 patients with stage I CCC treated with optimal or nonoptimal staging surgery. 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). 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.