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Cited by 19Ovarian cancer diagnosis and treatmentEndometrial and Cervical Cancer TreatmentsIntraperitoneal and Appendiceal Malignancies

Patterns of recurrence and role of pelvic radiotherapy in ovarian clear cell adenocarcinoma

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Macrie, Bryan D., Strauss, Jonathan B., Helenowski, Irene B., Rademaker, Alfred, Schink, Julian C., Lurain, John R., Small, William·2014·International Journal of Gynecological Cancer
DOI 10.1097/igc.0000000000000270
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Abstract

Objective(s) The aims of this study were to analyze patterns of recurrence in patients with ovarian clear cell adenocarcinoma (CCA) and to evaluate the role of pelvic radiotherapy (RT).Methods and materials All patients with ovarian CCA treated at a single institution between 1989 and 2012 were identified, and their medical records were reviewed. Eligibility criteria included histologic diagnosis of pure CCA of the ovary, surgical staging for International Federation of Gynecology and Obstetrics stage I-to-IIIC disease, and adjuvant or neoadjuvant chemotherapy. Selected end points were 3-, 5-, and 8-year cumulative incidence of pelvic recurrence (CIPR).Results Fifty-six patients met eligibility criteria. Most received intravenous carboplatin and paclitaxel for a median of 6 cycles. Six patients (10.7%) received pelvic RT, and 50 (89.3%) did not. Pelvic RT patients had stage I-to-IIC disease. Median follow-up was 39 months (range, 1-69 months). For the group as a whole, 14 patients (25%) had initial disease recurrence involving the pelvis, whereas 6 (10.7%) had first recurrence outside the pelvis. Three-, 5- and 8-year CIPR were 28.2%, 38.5%, and 43.2%, respectively. There was no significant difference in 3-, 5-, or 8-year CIPR between the group of patients receiving RT (20%, 20%, and 20%) and a group of patients with stages I to IIC who did not receive RT (9.9%, 22.4%, and 30.2%), P = 0.22. During RT, patients developed mild grade 1-to-2 side effects. After RT, 1 patient developed lower extremity lymphedema with recurrent cellulitis. One patient who developed small bowel obstruction before RT developed small bowel radiation enteritis and obstruction after RT, ultimately requiring surgical intervention.Conclusions These findings suggest that ovarian CCA exhibits a propensity for pelvic recurrence after surgery and chemotherapy. RT, a local treatment that can effectively sterilize microscopic tumor cells, may benefit patients with this disease. Prospective studies with sufficient statistical power are warranted to further evaluate the role of RT.

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  • Some series report an improvement in 5-year overall survival and progression free survival using abdominal radiation for ovarian carcinomas, especially for CCC.

    “Some series report an improvement in 5-year overall survival and progression free survival using abdominal radiation for ovarian carcinomas, especially for CCC (Hoskins et al., 2012, Macrie et al., 2014).”

    From Clear cell carcinoma arising from abdominal wall endometriosis – Brief report and review of the literature (2017) · cites this paper as Macrie et al., 2014

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Authors
Macrie, B. D., Strauss, J. B., Helenowski, I. B., Rademaker, A., Schink, J. C., Lurain, J. R., & Small, W.
Affiliations
  • Northwestern University (US)
  • Loyola University Chicago (US)
ORCID
Venue
International Journal of Gynecological Cancer
Publisher
Elsevier BV
Published
2014-11
Volume
24
Issue
9
Pages
1597-1602
ISSN
1048-891X (ISSN-L)
DOI
10.1097/igc.0000000000000270
OpenAlex
W1990589147
Cited by
19
References
30
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 1
FWCI
3.24
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Gynecological Cancer (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
  • Health Sciences › Medicine › Surgery › Intraperitoneal and Appendiceal Malignancies
Keywords
ovarian clear cell carcinoma, pelvic recurrence, pelvic radiotherapy, recurrence patterns, adjuvant chemotherapy, carboplatin, paclitaxel, radiation toxicity, lymphedema
MeSH terms
Carcinoma, Ovarian Epithelial, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Chicago, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Pelvic Neoplasms, Prognosis, Retrospective Studies, Incidence, Endometrial Neoplasms, Adenocarcinoma, Clear Cell, Neoplasm Grading

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