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Annals of Oncology Advance Access originally published online on February 4, 2009
Annals of Oncology 2009 20(6):1032-1036; doi:10.1093/annonc/mdn764
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gynecologic tumors

Prognostic significance of histological grade in clear-cell carcinoma of the ovary: a retrospective study of Korean Gynecologic Oncology Group

S.-Y. Ryu1, S.-I. Park1, B.-H. Nam2, I. Kim3, C. W. Yoo4, J.-H. Nam5, K. H. Lee6, C.-H. Cho7, J.-H. Kim5, S. Y. Park8, B.-G. Kim9 and S.-B. Kang10,*

1 Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, KIRAMS, Seoul
2 Center for Clinical Trials, National Cancer Center, Gyeonggi
3 Department of Pathology, Guro Hospital, Korea University College of Medicine, Seoul
4 Department of Pathology, National Cancer Center, Gyeonggi-do
5 Department of Obstetrics and Gynecology, Asan Medical Center, School of Medicine, Ulsan University, Seoul
6 Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, School of Medicine, Kwandong University
7 Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu
8 Department of Obstetrics and Gynecology, National Cancer Center, Gyeonggi-do
9 Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine
10 Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea

* Correspondence to: Prof. S.-B. Kang, M.D., Ph.D., Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea. Tel: +82-2-2072-2380; Fax: +82-2-762-3599; E-mail: ksboo308{at}plaza.snu.ac.kr

Background: This study was to investigate the prognostic significance of clinicopathologic characteristics in patients with clear-cell carcinoma (CCC) of the ovary.

Materials and methods: Two hundred and one patients with CCC of the ovary were registered in the Korean Gynecologic Oncology Group. The Korean Gynecologic Pathology Study Group reviewed the pathological slides centrally, using a universal grading system. The prognostic significances of clinicopathologic factors were evaluated by multivariate analysis.

Results: Most of the patients were diagnosed at an early stage (stage I, 61.3%), and the overall 5-year survival rate was 57%. Early-stage disease showed a favorable prognosis, but advanced diseases showed poor prognosis. Stage of disease was the only significant prognostic factor on multivariate analysis (P < 0.001). However, universal grade and residual tumor also showed prognostic significance on the forward stepwise likelihood ratio test. There was no survival difference observed between patients treated with paclitaxel-based and those treated with platinum-based combination chemotherapy.

Conclusions: The stage, residual tumor, and universal grade were significant prognostic factors in patients with CCC of the ovary. The universal grading system is applicable in determining prognosis of CCC of the ovary. Further clinical trials for optimal chemotherapy are in need.

Key words: clear-cell carcinoma, ovary, prognosis, universal grade

Received for publication September 25, 2008. Revision received November 25, 2008. Accepted for publication November 26, 2008.


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