Clear cell carcinoma of the ovary: A distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease
Clear cell carcinoma of the ovary: A distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease
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DOI：
10.1006/gyno.1996.0065
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发表时间：
1996-03-01
影响因子：
4.7
通讯作者：
Fuller, AF
中科院分区：
文献类型：
--
作者：
Goff, BA;delaCuesta, RS;Fuller, AF
在1982年至1992年期间，24名患有III期透明细胞卵巢癌的妇女从肿瘤登记处被确定。1987年至1989年治疗的34例III期乳头状浆液性肿瘤患者作为对照。所有患者均接受肿瘤细胞减灭术，随后接受常规铂类药物化疗。在透明细胞组织学的女性中，9例（37.5%）手术标本中有子宫内膜异位症，而乳头状浆液性组中有1例（3%）（P = 0.002）。10名（42%）透明细胞组织学女性在治疗过程中发生血栓栓塞事件，而乳头状浆液性组为6名（18%）（P = 0.05）。在透明细胞组织学组中，总体而言，70%的女性患有进展性疾病。52%的患者在接受铂类化疗时出现临床进展。此外，四名患者在二次剖腹探查时发现疾病进展。只有两名患者的病理完全缓解。在乳头状浆液性组织学组中，29%的患者在化疗期间疾病进展（P = 0.005）。透明细胞组织学女性的中位生存期为12个月，乳头状浆液性乳腺癌为22个月（P = 0.02）。对于透明细胞组织学的妇女，单变量分析用于评估预后因素。年龄小于50岁是预后不良的因素（P = 0.045）。存在子宫内膜异位症、血栓栓塞事件或最佳细胞减灭术不是预后因素（P = 0.67，P = 0.34，P = 0.39）。晚期卵巢透明细胞癌患者对常规铂类化疗的反应较差，总体预后较差。(C)出版社：Academic Press，Inc.
Between 1982 and 1992, 24 women with Stage III clear cell ovarian cancer were identified from the tumor registry. Thirty-four women with Stage III papillary serous tumors treated between 1987 and 1989 were used as a comparison. All patients underwent cytoreductive surgery followed by conventional platinum-based chemotherapy. In the women with clear cell histology, nine (37.5%) had endometriosis in the surgical specimen compared with one (3%) in the papillary serous group (P = 0.002). Ten women (42%) with clear cell histology experienced a thromboembolic event during the course of treatment, compared to six (18%) in the papillary serous group (P = 0.05). In the group with clear cell histology, overall, 70% of women had progressive disease. Fifty-two percent experienced clinical progression while receiving platinum-based chemotherapy. In addition, four patients were found to have progressive disease at second-look laparotomy. Only two patients had a pathologic complete response. In the group with papillary serous histology, 29% overall had progressive disease while on chemotherapy (P = 0.005). The median survival for the women with clear cell histology was 12 months compared to 22 months for those with papillary serous (P = 0.02). For women with clear cell histology, univariate analysis was used to evaluate prognostic factors. Age less than 50 was a poor prognostic factor (P = 0.045). The presence of endometriosis, thromboembolic event, or optimal cytoreduction were not prognostic factors (P = 0.67, P = 0.34, P = 0.39). Patients with advanced clear cell ovarian cancer have a poor response to conventional platinum-based chemotherapy and overall prognosis is poor. (C) 1996 Academic Press, Inc.