Is There a Survival Benefit for Patients with Advanced Ovarian Clear Cell Carcinoma Who Complete More Than 6 Cycles of Postoperative Chemotherapy?

CONCLUSION

In summary, for patients with advanced OCCC, the diameter of postoperative residual tumor is an independent factor affecting prognosis. Gynecologic oncologists should improve their surgical skills as much as possible because the initial staging of ovarian cancer significantly affects the prognosis. However, regardless of whether the initial staging operation is complete, the appropriate cycle of postoperative adjuvant chemotherapy should be carefully selected. More than six cycles of chemotherapy do not improve prognosis but may increase toxicity and drug resistance.

Funding

This work was supported by the National Natural Science Foundation of China (No. 8197103302).

Disclosure

The authors report no competing financial interests or conflicts of interest in this work.

References

1. Machida H, Matsuo K, Yamagami W, et al. Trends and characteristics of epithelial ovarian cancer in Japan between 2002 and 2015: a JSGO-JSOG joint study. Gynecol Oncol. 2019;153:589–596. doi:10.1016/j.ygyno.2019.03.243

2. Kim SI, Lee JW, Lee M, et al. Genomic landscape of ovarian clear cell carcinoma via whole exome sequencing. Gynecol Oncol. 2018;148:375–382. doi:10.1016/j.ygyno.2017.12.005

3. Sugiyama T, Okamoto A, Enomoto T, et al. Randomized Phase III trial of irinotecan plus cisplatin compared with paclitaxel plus carboplatin as first-line chemotherapy for ovarian clear cell carcinoma: JGOG3017/GCIG trial. J Clin Oncol. 2016;34:2881–2887. doi:10.1200/JCO.2016.66.9010

4. Schnack TH, Høgdall E, Nedergaard L, Høgdall C. Demographic clinical and prognostic factors of primary ovarian adenocarcinomas of serous and clear cell histology-a comparative study. Int J Gynecol Cancer. 2016;26:82–90. doi:10.1097/IGC.0000000000000585

5. Köbel M, Kalloger SE, Huntsman DG, et al. Differences in tumor type in low-stage versus high-stage ovarian carcinomas. Int J Gynecol Pathol. 2010;29:203–211. doi:10.1097/PGP.0b013e3181c042b6

6. Anglesio MS, Carey MS, Köbel M, Mackay H, Huntsman DG. Vancouver ovarian clear cell symposium speakers. clear cell carcinoma of the ovary: a report from the first ovarian clear cell symposium, June 24th, 2010. Gynecol Oncol. 2011;121:407–415. doi:10.1016/j.ygyno.2011.01.005

7. Wang S, Qiu L, Lang JH, et al. Clinical analysis of ovarian epithelial carcinoma with coexisting pelvic endometriosis. Am J Obstet Gynecol. 2013;208:413.e1–5. doi:10.1016/j.ajog.2012.12.004

8. Kobayashi H, Sumimoto K, Moniwa N, et al. Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan. Int J Gynecol Cancer. 2007;17:37–43. doi:10.1111/j.1525-1438.2006.00754.x

9. Fujiwara K, Shintani D, Nishikawa T. Clear-cell carcinoma of the ovary. Ann Oncol. 2016;27(Suppl 1):i50–50i52. doi:10.1093/annonc/mdw086

10. Kaur S, Kerkar RA, Maheshwari A, Shylasree TS, Gupta S, Deodhar K. Clinical characteristics with patterns of relapse and survival analysis of ovarian clear cell carcinoma. Indian J Cancer. 2016;53:288–291. doi:10.4103/0019-509X.197719

11. Okamoto A, Sugiyama T, Hamano T, et al. Randomized phase III trial of paclitaxel/carboplatin (PC) versus cisplatin/irinotecan (CPT-P) as first-line chemotherapy in patients with clear cell carcinoma (CCC) of the ovary: a Japanese gynecologic oncology group (JGOG)/GCIG study. J Clin Oncol. 2014;32(suppl 5):5507. doi:10.1200/jco.2014.32.15_suppl.5507

12. Ozols RF, Bundy BN, Greer BE, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a gynecologic oncology group study. J Clin Oncol. 2003;21:3194–3200. doi:10.1200/JCO.2003.02.153

13. Itamochi H, Kigawa J, Terakawa N. Mechanisms of chemoresistance and poor prognosis in ovarian clear cell carcinoma. Cancer Sci. 2008;99:653–658. doi:10.1111/j.1349-7006.2008.00747.x

14. Sugiyama T, Kamura T, Kigawa J, et al. Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer. 2000;88:2584–2589. doi:10.1002/1097-0142(20000601)88:11<2584::AID-CNCR22>3.0.CO;2-5

15. Oliver KE, Brady WE, Birrer M, et al. An evaluation of progression free survival and overall survival of ovarian cancer patients with clear cell carcinoma versus serous carcinoma treated with platinum therapy: an NRG oncology/gynecologic oncology group experience. Gynecol Oncol. 2017;147:243–249. doi:10.1016/j.ygyno.2017.08.004

16. Al-Barrak J, Santos JL, Tinker A, et al. Exploring palliative treatment outcomes in women with advanced or recurrent ovarian clear cell carcinoma. Gynecol Oncol. 2011;122:107–110. doi:10.1016/j.ygyno.2011.03.011

17. Pignata S, Scambia G, Ferrandina G, et al. Carboplatin plus paclitaxel versus carboplatin plus pegylated liposomal doxorubicin as first-line treatment for patients with ovarian cancer: the MITO-2 randomized phase III trial. J Clin Oncol. 2011;29:3628–3635. doi:10.1200/JCO.2010.33.8566

18. Bell J, Brady MF, Young RC, et al. Randomized phase III trial of three versus six cycles of adjuvant carboplatin and paclitaxel in early stage epithelial ovarian carcinoma: a gynecologic oncology group study. Gynecol Oncol. 2006;102:432–439. doi:10.1016/j.ygyno.2006.06.013

19. Bookman MA, Brady MF, McGuire WP, et al. Evaluation of new platinum-based treatment regimens in advanced-stage ovarian cancer: a Phase III trial of the gynecologic cancer intergroup. J Clin Oncol. 2009;27:1419–1425. doi:10.1200/JCO.2008.19.1684

20. Prendergast EN, Holzapfel M, Mueller JJ, et al. Three versus six cycles of adjuvant platinum-based chemotherapy in early stage clear cell ovarian carcinoma – a multi-institutional cohort. Gynecol Oncol. 2017;144:274–278. doi:10.1016/j.ygyno.2016.12.004

21. Bertelsen K, Grenman S, Rustin GJ. How long should first-line chemotherapy continue. Ann Oncol. 1999;10(Suppl 1):17–20. doi:10.1016/S0923-7534(20)31479-4

22. Pectasides D, Fountzilas G, Aravantinos G, et al. Advanced stage clear-cell epithelial ovarian cancer: the Hellenic Cooperative Oncology Group experience. Gynecol Oncol. 2006;102:285–291. doi:10.1016/j.ygyno.2005.12.038

23. Suidan RS, Zhou Q, Iasonos A, et al. Prognostic significance of the number of postoperative intraperitoneal chemotherapy cycles for patients with advanced epithelial ovarian cancer. Int J Gynecol Cancer. 2015;25:599–606. doi:10.1097/IGC.0000000000000389

24. Winter WE 3rd, Maxwell GL, Tian C, et al. Prognostic factors for stage III epithelial ovarian cancer: a gynecologic oncology group study. J Clin Oncol. 2007;25:3621–3627. doi:10.1200/JCO.2006.10.2517

25. Tewari D, Java JJ, Salani R, et al. Long-term survival advantage and prognostic factors associated with intraperitoneal chemotherapy treatment in advanced ovarian cancer: a gynecologic oncology group study. J Clin Oncol. 2015;33:1460–1466. doi:10.1200/JCO.2014.55.9898

26. Takano M, Sugiyama T, Yaegashi N, et al. Less impact of adjuvant chemotherapy for stage I clear cell carcinoma of the ovary: a retrospective Japan Clear Cell Carcinoma Study. Int J Gynecol Cancer. 2010;20:1506–1510.

27. Utsunomiya H, Akahira J, Tanno S, et al. Paclitaxel-platinum combination chemotherapy for advanced or recurrent ovarian clear cell adenocarcinoma: a multicenter trial. Int J Gynecol Cancer. 2006;16:52–56. doi:10.1111/j.1525-1438.2006.00289.x

Source: Cancer Management and Research.
Originally published November 13, 2020.

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