Survival probability in ovarian clear cell adenocarcinoma

Objective. The aim of this study was to evaluate the 5-year survival probab ility (SP) of patients treated for ovarian clear cell adenocarcinoma (OCCA) at a single tertiary institution and to compare it to the 5-year SP of pat ients with other histologic subtypes of epithelial ovarian cancer. Methods. Sixty-four patients with pure OCCA treated at the Cleveland Clinic Foundation from 1981 to 1996 were retrospectively identified and clinical information was abstracted. All histologic materials were reviewed by a sin gle gynecologic pathologist. SP was calculated by the Kaplan-Meier method. SPs for OCCA patients were compared to that of other high-grade epithelial ovarian cancer patients in the gynecologic tumor registry. Cox proportional hazards modeling was used to identify variables associated with decreased SP. Results. The FIGO stages of OCCA study patients were Stage I, 31 (50%), Sta ge II, 6 (10%), Stage III, 17 (27%), and Stage IV, 8 (13%) (2 patients unst aged). Forty-four patients had no gross residual cancer at the completion o f initial surgery while 9 patients had less than or equal to 1 cm diameter residual and 10 had >1 cm residual. Forty-ive (73%) received postoperative chemotherapy. The median follow-up for surviving patients is 97 months (ran ge 38 to 209 months). The overall 5-year SP of OCCA patients is 50% with li mited disease (Stages I and II) patients having a 5-year SP of 72% versus 1 7% 5-year SP in patients with advanced disease (P < 0.001). FIGO stage was most predictive of outcome. The overall 5-year SP of OCCA patients (50%) di ffered significantly (P < 0.05) from that of other ovarian cancer registry patients (30%). OCCA patients with limited cancer survived similarly to reg istry patients (72 vs 72%) as did patients with advanced OCCA compared with registry patients (17 vs 22%). Conclusions. When controlled for grade and stage, the overall survival with OCCA is identical to that of other high-grade epithelial ovarian cancers. Factors that account for the better overall survival of OCCA patients are m ore favorable disease stage, younger age, and improved debulking status. (C ) 1999 Academic Press.