Research Papers:

The possible existence of occult metastasis in patients with ovarian clear-cell carcinoma who underwent complete resection without any residual tumours

Hiroaki Kajiyama _, Shiro Suzuki, Masato Yoshihara, Kimihiro Nishino, Nobuhisa Yoshikawa, Fumi Utsumi, Kaoru Niimi, Mika Mizuno, Michiyasu Kawai, Hidenori Oguchi, Kimio Mizuno, Osamu Yamamuro, Tetsuro Nagasaka, Kiyosumi Shibata and Fumitaka Kikkawa

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Oncotarget. 2018; 9:6298-6307. https://doi.org/10.18632/oncotarget.23921

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Hiroaki Kajiyama1, Shiro Suzuki1, Masato Yoshihara1, Kimihiro Nishino1, Nobuhisa Yoshikawa1, Fumi Utsumi1, Kaoru Niimi1, Mika Mizuno2, Michiyasu Kawai3, Hidenori Oguchi4, Kimio Mizuno5, Osamu Yamamuro6, Tetsuro Nagasaka7, Kiyosumi Shibata8 and Fumitaka Kikkawa1

1Department of Obstetrics and Gynecology, Graduate School of Medicine, Nagoya University, Nagoya, Japan

2Department of Gynecology, Aichi Cancer Center Hospital, Nagoya, Japan

3Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Japan

4Department of Obstetrics and Gynecology, Toyota Memorial Hospital, Toyota, Japan

5Department of Obstetrics and Gynecology, Nagoya First Red-Cross Hospital, Nagoya, Japan

6Department of Obstetrics and Gynecology, Nagoya Second Red-Cross Hospital, Nagoya, Japan

7Division of Medical Laboratory Sciences, School of Health Science, Nagoya University, Nagoya, Japan

8Department of Obstetrics and Gynecology, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan

Correspondence to:

Hiroaki Kajiyama, email: [email protected]

Keywords: epithelial ovarian carcinoma; clear-cell carcinoma; recurrence; metastasis

Abbreviations: CCC: clear-cell carcinoma; RT: residual tumors; CIR: cumulative incidence of recurrence; CID: cumulative incidence of death; PRS: post-recurrence survival

Received: June 06, 2017     Accepted: July 25, 2017     Published: January 04, 2018


The objective of this study was to estimate the frequency of possible occult metastasis through long-term survival analyses in patients with clear cell carcinoma (CCC) who had undergone complete resection. During the period of 1990-2015, 799 patients with stage I-IV CCC were identified in the TOTSG database. Of these, a total of 528 patients without a residual tumor were enrolled in the study and classified into four groups: Group 1: FIGO stage IA-IB (N=104), Group 2: FIGO stage IC1 (N=170), Group 3: FIGO stage IC2/IC3 (N=98), and Group 4: FIGO stage II-III (no residual tumor: N=156). Cumulative incidences of recurrence (CIR) and death (CID) were examined. The median age was 54, ranging from 29-87. The 5-year CIR / CID of each group were as follows: Group 1 (7.3% / 3.8%), Group 2 (14.3% / 10.2%), Group 3 (37.7% / 18.4%), and Group 4 (46.5% / 33.8%), respectively {P<0.0001 (recurrence) / P<0.0001 (death)}. Furthermore, confining analysis to relapsed patients, 1-, 2-, and 3-year CID after recurrence were 41.5, 60.9, and 73.9, respectively. Confining analyses to patients with sufficient information about adjuvant chemotherapy, the 5-year CIR / CID of stage IA-IC1 patients with or without chemotherapy were as follows: recurrence {13.0% (yes) / 9.6% (no)}, death {9.3% (yes) / 4.2% (no)}, respectively {P=0.947 (CIR) / P=0.224 (CID)}. CCC patients staged greater than IC2/ IC3 show a marked risk of mortality, even after complete surgical resection.

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