Comparison of advanced stage mucinous epithelial ovarian cancer and serous epithelial ovarian cancer with regard to chemosensitivity and survival outcome: a matched case-control study

다국어 초록 (Multilingual Abstract)

Objective: The aim of this study was to compare clinicopathologic characteristics, surgery outcomes and survival outcomes of patients with stage III and IV mucinous epithelial ovarian cancer (mEOC) and serous epithelial ovarian carcinoma (sEOC).
Methods: Patients who had surgery for advanced stage (III or IV) mEOC were evaluated retrospectively and defined as the study group. Women with sEOC who were matched for age and stage of disease were randomly chosen from the database and defined as the control group. The baseline disease characteristics of patients and platinum-based chemotherapy efficacy (response rate, progression-free survival and overall survival [OS]) were compared.
Results: A total of 138 women were included in the study: 50 women in the mEOC group and 88 in the sEOC group. Patients in the mEOC group had significantly less grade 3 tumors and CA-125 levels and higher rate of para-aortic and pelvic lymph node metastasis. Patients in the mEOC group had significantly less platinum sensitive disease (57.9% vs. 70.8%; p=0.03) and had significantly poorer OS outcome when compared to the sEOC group (p=0.001). The risk of death for mEOC patients was significantly higher than for sEOC patients (hazard ratio, 2.14; 95% confidence interval, 1.34 to 3.42).
Conclusion: Advanced stage mEOC patients have more platinum resistance disease and poorer survival outcome when compared to advanced stage sEOC. Therefore, novel chemotherapy strategies are warranted to improve survival outcome in patients with mEOC.

참고문헌 (Reference)

1 Cheng X., "The role of secondary cytoreductive surgery for recurrent mucinous epithelial ovarian cancer(mEOC)" 35 : 1105-1108, 2009

2 Bristow RE., "Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era : a meta-analysis" 20 : 1248-1259, 2002

3 Griffiths CT, "Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma" 42 : 101-104, 1975

4 Zang RY., "Secondary cytoreductive surgery for patients with relapsed epithelial ovarian carcinoma: who benefits?" 100 : 1152-1161, 2004

5 Nakayama K., "Prognostic value of overexpression of p53 in human ovarian carcinoma patients receiving cisplatin" 192 : 227-235, 2003

6 Mackay HJ., "Prognostic relevance of uncommon ovarian histology in women with stage III/IV epithelial ovarian cancer" 20 : 945-952, 2010

7 Teramukai S., "PIEPOC : a new prognostic index for advanced epithelial ovarian cancer : Japan Multinational Trial Organization OC01-01" 25 : 3302-3306, 2007

8 Schiavone MB, "Natural history and outcome of mucinous carcinoma of the ovary" 205 (205): 1-8, 2011

9 Hess V., "Mucinous epithelial ovarian cancer : a separate entity requiring specific treatment" 22 : 1040-1044, 2004

10 Bamias A., "Mucinous but not clear cell histology is associated with inferior survival in patients with advanced stage ovarian carcinoma treated with platinum-paclitaxel chemotherapy" 116 : 1462-1468, 2010

11 Alexandre J., "Mucinous advanced epithelial ovarian carcinoma: clinical presentation and sensitivity to platinum-paclitaxel-based chemotherapy, the GINECO experience" 21 : 2377-2381, 2010

12 Omura GA., "Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma : the Gynecologic Oncology Group experience" 9 : 1138-1150, 1991

13 Chan JK., "Do clear cell ovarian carcinomas have poorer prognosis compared to other epithelial cell types? A study of 1411 clear cell ovarian cancers" 109 : 370-376, 2008

14 Shimizu Y., "Cytotoxic agents active against mucinous adenocarcinoma of the ovary" 5 : 99-101, 1998

15 McGuire WP., "Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer" 334 : 1-6, 1996

16 Trimble EL., "Current academic clinical trials in ovarian cancer: Gynecologic Cancer Intergroup and US National Cancer Institute Clinical Trials Planning Meeting, May 2009" 20 : 1290-1298, 2010

17 Shimada M., "Clinicopathological characteristics of mucinous adenocarcinoma of the ovary" 113 : 331-334, 2009

18 Tian C., "CA-125 change after chemotherapy in prediction of treatment outcome among advanced mucinous and clear cell epithelial ovarian cancers : a Gynecologic Oncology Group study" 115 : 1395-1403, 2009

19 Pectasides D., "Advanced stage mucinous epithelial ovarian cancer : the Hellenic Cooperative Oncology Group experience" 97 : 436-441, 2005

20 Zaino RJ., "Advanced stage mucinous adenocarcinoma of the ovary is both rare and highly lethal : a Gynecologic Oncology Group study" 117 : 554-562, 2011

21 Pignata S., "Activity of chemotherapy in mucinous ovarian cancer with a recurrence free interval of more than 6 months : results from the SOCRATES retrospective study" 8 : 252-, 2008

22 Shimizu Y., "A phase II study of combined CPT-11 and mitomycin-C in platinum refractory clear cell and mucinous ovarian carcinoma" 27 : 650-656, 1998