Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: A 10-Year Retrospective Study

Abstract

Background

Ovarian clear cell carcinoma (OCCC) is a special pathological type of epithelial ovarian carcinoma (EOC), we conducted this research in order to investigate the clinical characteristics and outcomes of OCCC and to provide additional supporting evidence to aid in the clinical diagnosis and management.

Methods

This was a retrospective study investigating the clinical characteristics and survival outcomes of 87 patients with OCCC treated at our center between January 2010 and March 2020. Survival analysis was also performed on 179 patients with OCCC obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registry database.

Results

The median age of participants was 49.28 ± 9.8 years old, with 74.71% diagnosed at early stage. Median CA125 level was 607.26 IU/mL, with 23.94% having normal CA125 levels. 16 patients (18.39%) had co-existing endometriosis and 8 patients (9.2%) developed venous thromboembolism (VTE). There were 5 patients received suboptimal cytoreduction. 67 patients (77.01%) underwent lymphadenectomy, and only 3 (4.48%) were found to have positive lymph nodes. Patients diagnosed at an early stage had higher 3-year overall survival (OS) and progression-free survival (PFS) rates than those with advanced stage OCCC. CA199 (P = 0.025) and ascites (P = 0.001) were significantly associated with OS, while HE4 (P = 0.027) and ascites (P = 0.001) were significantly associated with PFS. Analysis of data from the SEER database showed that positive lymph nodes is also an independent prognostic factor for OS (P = 0.001).

Conclusions

OCCC often presents at an early stage and young age with a mildly elevated CA125. CA199, HE4, massive ascites and positive lymph node are independent prognostic factors.