Residual Tumor Diameter Predicts Progression After Primary Debulking Surgery of Ovarian Clear Cell Carcinoma (OCCC): Clinicopathologic Study of Stage II-IV OCCC Patients from a Single Institution

Abstract

Yuying Shi,1– 3,* Mengyuan Dai,1– 3,* Yaxing Zhang,1– 3 Yuwen Qi,1– 3 Zhen Li,1– 3 Hongbing Cai1– 3 1Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, Hubei, People’s Republic of China; 3Hubei Cancer Clinical Study Center, Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongbing CaiZhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of ChinaTel [phone]Email [email protected]: Ovarian clear cell carcinoma (OCCC) is a subtype of ovarian cancer characterized by highly aggressive and poor prognosis. However, it is unclear what factors are associated with OCCC recurrence and death. The study aimed to evaluate whether residual tumor diameter after primary debulking surgery, or other clinicopathological features play roles in predicting survival outcome in stage II–IV OCCC patients.Material and Methods: We present a retrospective study of OCCC patients with stage II–IV in our department from 2010 to 2015. Kaplan–Meier method was used to draw a survival curve. Survival analysis was performed using Log-rank test for univariate analysis and COX proportional risk regression model for multivariate analysis.Results: In this cohort of 78 patients who underwent primary debulking surgery, 47 patients had disease recurrence and 32 cases died. On univariate analysis, FIGO stage, residual tumor diameter and ascites were significant predictors of 3-year PFS (P values< 0.05) and OS (P values< 0.05). On multivariate analysis, the residual tumor diameter was an independent prognostic factor for 3-year PFS and OS (P values< 0.05). The outcomes of patients in residual-free group were significantly better than those in the residual tumor diameter 0– 1cm and > 1cm group (PFS: P=0.000, OS: P=0.001), but there was no significant difference in prognosis between 0– 1cm and > 1cm group (P values > 0.05). Greater residual tumor diameter predicted progression on cox analysis in patients with stage III, but not for patients with stage IV.Conclusion: Residual tumor diameter is prognostic after surgery for OCCC. Achieving no residual disease will significantly improve the prognosis in advanced OCCC patients.Keywords: ovarian clear cell carcinoma, residual tumor diameter, progression

Keywords

• ovarian clear cell carcinoma
• residual tumor diameter
• progression