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Impact of Surgical Staging in Stage I Clear Cell Adenocarcinoma of the Ovary
  1. Kayo Suzuki, MD*,
  2. Satoshi Takakura, MD, PhD,
  3. Motoaki Saito, MD, PhD,
  4. Asuka Morikawa, MD,
  5. Jiro Suzuki, MD§,
  6. Kazuaki Takahashi, MD,
  7. Chie Nagata, MD, PhD, MPH,
  8. Nozomu Yanaihara, MD, PhD,
  9. Hiroshi Tanabe, MD, PhD* and
  10. Aikou Okamoto, MD, PhD
  1. *Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, Kashiwa; and
  2. Department of Obstetrics and Gynecology, The Jikei University School of Medicine;
  3. Department of Obstetrics and Gynecology, The Jikei University Daisan Hospital; and
  4. §Department of Obstetrics and Gynecology, The Jikei University Katsushika Medical Center, Tokyo, Japan.
  1. Address correspondence and reprint requests to Satoshi Takakura MD, PhD, Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. E-mail: stakakur{at}jikei.ac.jp.
  1. An outline of this study was presented at the 65th Annual Congress of the Japanese Society of Obstetrics and Gynecology (Sapporo, Japan, 2013) by K.S.

Abstract

Aim 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.

  • Ovarian cancer
  • Clear cell carcinoma
  • Surgical staging
  • Lymphadenectomy
  • Adjuvant chemotherapy

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Footnotes

  • This work was supported in part by JSPS KAKENHI (grant 25462616).

  • The authors declare no conflicts of interest.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

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