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Postrecurrent Oncologic Outcome of Patients With Ovarian Clear Cell Carcinoma
  1. Hiroaki Kajiyama, MD, PhD*,
  2. Kiyosumi Shibata, MD, PhD*,
  3. Mika Mizuno, MD, PhD*,
  4. Eiko Yamamoto, MD, PhD*,
  5. Sawako Fujiwara, MD, PhD*,
  6. Tomokazu Umezu, MD, PhD*,
  7. Shiro Suzuki, MD, PhD*,
  8. Toru Nakanishi, MD, PhD,
  9. Tetsuro Nagasaka, MD, PhD and
  10. Fumitaka Kikkawa, MD, PhD*
  1. *Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine;
  2. Department of Gynecology, Aichi Cancer Center Hospital; and
  3. Department of Medical Technology,Nagoya University School of Health Science, Nagoya, Japan.
  1. Address correspondence and reprint requests to Hiroaki Kajiyama, MD, PhD, Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-cho 65, Showa-ku, Nagoya 466-8550, Japan. E-mail:


Objectives To estimate the long-term clinical outcome of patients with recurrent clear cell carcinoma (RCCC) of the ovary in comparison with those with recurrent serous adenocarcinoma (RSAC).

Patients and Methods In this study, 113 patients with RCCC and 365 patients with RSAC were analyzed. The pathological slides were evaluated under central pathological review. End points were the overall survival (OS), postrecurrence survival (PRS), and timing of death of mortality cases.

Results The 5-year OS and PRS rates of patients with RCCC were 22.5 and 13.2%, respectively. In both OS and PRS, the prognosis of patients with RCCC was significantly poorer than that of the patients with RSAC (OS: P = 0.0007; PRS: P < 0.0001). Moreover, regardless of the status of the residual tumor (RT) at the initial surgery, the OS and PRS of the patients with RCCC were markedly shorter than those with RSAC (RT [−]: OS, P = 0.0005: PRS, P = 0.0002: RT [+]: OS, P < 0.0001: PRS, P < 0.0001). In multivariable analysis, the histological type was a significantly poorer prognostic indicator for OS and PRS (OS [RCCC vs RSAC]: hazard ratio, 2.302: 95% confidence interval, 1.723–3.076; P < 0.0001: PRS [RCCC vs RSAC]; hazard ratio, 2.353: 95% confidence interval, 1.756–3.155; P < 0.0001). Even in the deceased patients (n = 350), the rate of patients with RCCC dying within 12 months of recurrence was higher than that of RSAC (RCCC, 67.8%; RSAC, 40.7%; [P < 0.0001]).

Conclusions The long-term clinical outcome of patients with RCCC was extremely poor. We confirmed that RCCC should be investigated as a different malignancy compared with RSAC.

  • Recurrent ovarian cancer
  • Clear cell carcinoma (CCC)
  • Overall survival
  • Postrecurrence survival

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  • All authors declare that there are no financial disclosures, conflicts of interest, and/or acknowledgments.