LYMPHADENECTOMY HAS PROGNOSTIC ROLE IN CLEAR CELL OVARIAN CANCER

Int J Gynecol Cancer. 2011 May 30. [Epub ahead of print]

Surgical and Medical Treatment of Clear Cell Ovarian Cancer: Results From the
Multicenter Italian Trials in Ovarian Cancer (MITO) 9 Retrospective Study.

Magazzino F, Katsaros D, Ottaiano A, Gadducci A, Pisano C, Sorio R, Rabaiotti E, 
Scambia G, Cormio G, Scarampi L, Greggi S, Savarese A, Marinaccio M, Scollo P,
Pignata S.

*II Ginecologia e Ostetricia, Azienda Ospedaliera Policlinico, Bari, Italy;
†Ginecologica, Azienda Ospedaliera O.I.R.M. - S. Anna, Università di Torino,
Turin, Italy; ‡Istituto Nazionale Tumori, Naples, Italy; §Ginecologia, Università
di Pisa, Pisa, Italy; ∥Oncologia Medica, CRO Aviano, Aviano, Italy; ¶Ginecologia,
Ospedale San Raffaele, Milan, Italy; #Ginecologia Oncologica, Policlinico
Agostino Gemelli, Rome, Italy; **U. O. Oncologia, Regina Elena National Cancer
Institute, Rome, Italy; ††I Ginecologia e Ostetricia, Azienda Ospedaliera
Policlinico, Bari, Italy; and ‡‡Ginecologia ed Ostetricia, A.O. Cannizzaro,
Catania, Italy.

OBJECTIVE:: Clear cell ovarian carcinoma has a poorer prognosis compared with
other histological subtypes. MATERIALS AND METHODS:: The Multicenter Italian
Trials in Ovarian Cancer (MITO) 9 study retrospectively assessed an Italian
cohort of patients with clear cell ovarian cancer observed in the years 1991-2007
in 20 Italian centers. RESULTS:: A total of 240 patients with ovarian cancer were
analyzed. Forty-five percent of the patients had stage I disease. In 62.9%, clear
cell histology was pure, whereas in the other cases, a mixed population was
evident. Most of the cases underwent standard surgery, whereas in 7.1% of the
patients, a fertility-sparing surgery was given. Lymphadenectomy was performed in
47.9% (115/240) of the patients (54.3% in stages I and II; 39.2% in advanced
stage). Most of the patients were treated with platinum-based chemotherapy
including paclitaxel in 52.9%. Disease-free survival was longer in patients
undergoing lymphadenectomy at surgery (P = 0.0001), both in early stages (P =
0.0258) and in stage III and IV diseases (P = 0.0037). The impact of
lymphadenectomy was also evident on overall survival in patients with
advanced-stage disease. At multivariate analysis, lymphadenectomy (done vs not
done) and stage (I and II vs III and IV) were independently associated with
longer disease-free and overall survival, whereas front-line chemotherapy (with
vs without taxanes) was not significant. CONCLUSION:: This analysis suggests that
lymphadenectomy has a strong prognostic role for clear cell ovarian cancer
influencing disease-free survival and overall survival. The addition of
paclitaxel to platinum-based chemotherapy does not affect the outcome.