Five-year survival for stage IC or stage I grade 3 epithelial ovarian cancer treated with cisplatin-based chemotherapy

Purpose The objective of this study was to assess clinical outcomes and fertility in patients treated conservatively for unilateral stage I invasive epithelial ovarian cancer (EOC). Patients and Methods A multi-institutional retrospective investigation was undertaken to identify patients with unilateral stage I EOC treated with fertility-sparing surgery. Favorable histology was defined as grade 1 or grade 2 adenocarcinoma, excluding clear cell histology. Results A total of 211 patients (stage IA, n = 126; stage IC, n = 85) were identified from 30 institutions. Median duration of follow-up was 78 months. Five-year overall survival and recurrence-free survival were 100% and 97.8% for stage IA and favorable histology (n = 108), 100% and 100% for stage IA and clear cell histology (n = 15), 100% and 33.3% for stage IA and grade 3 (n = 3), 96.9% and 92.1% for stage IC and favorable histology (n = 67), 93.3% and 66.0% for stage IC and clear cell histology (n = 15), and 66.7% and 66.7% for stage IC and grade 3 (n = 3). Forty-five (53.6%) of 84 patients who were nulliparous at fertility-sparing surgery and married at the time of investigation gave birth to 56 healthy children. Conclusion Our data confirm that fertility-sparing surgery is a safe treatment for stage IA patients with favorable histology and suggest that stage IA patients with clear cell histology and stage IC patients with favorable histology can be candidates for fertility-sparing surgery followed by adjuvant chemotherapy.

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Prognostic significance of p53 immunostaining in epithelial ovarian cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1994.12.1.64 ◽

1994 ◽

Vol 12 (1) ◽

pp. 64-69 ◽

Cited By ~ 101

Author(s):

L C Hartmann ◽

K C Podratz ◽

G L Keeney ◽

N A Kamel ◽

J H Edmonson ◽

...

Keyword(s):

Ovarian Cancer ◽

Multivariate Analysis ◽

Epithelial Ovarian Cancer ◽

Univariate Analysis ◽

Prognostic Significance ◽

Stage I ◽

Stage Iii ◽

P53 Expression ◽

Independent Prognostic Significance ◽

Grade 3

PURPOSE To evaluate the prognostic significance of p53 expression in epithelial ovarian cancer, including a subset of stage I patients, and to look for correlations between p53 expression and other disease parameters, including stage, grade, age, histologic subtype, second-look results, ploidy, and percent S phase. PATIENTS AND METHODS We analyzed p53 expression in 284 patients with epithelial ovarian cancer using immunohistochemical techniques in paraffin-embedded specimens. There were 36 patients with stage I disease, 20 with stage II disease, 186 with stage III disease, and 42 with stage IV disease. RESULTS p53 immunoreactivity was present in 177 cases (62%). p53 expression was associated with grade 3 to 4 disease (P = .003). The following factors were associated with a decrease in overall survival in a univarate analysis: stage III or IV disease (P = .0001), grade 3 or 4 disease (P = .0001), age above the median (P = .0002), and p53 reactivity (P = .04). In a multivariate analysis, stage, grade, and age retained independent prognostic significance. In the subset of 36 stage I patients, p53 positively approached statistical significance (P = .10) as a negative prognostic factor in a univariate analysis. CONCLUSION Abnormalities of p53 expression occur commonly in epithelial ovarian cancer. Although associated with decreased survival in a univariate analysis, this biologic marker did not retain independent prognostic significance in a multivariate analysis. p53 expression should be studied in a larger cohort of early-stage patients, where accurate prognostic information is needed to direct therapy.

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Platinum plus cyclophosphamide plus radiotherapy is superior to platinum alone in 'high-risk' epithelial ovarian cancer (residual negative and either stage I or II, grade 3, or stage III, any grade)

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1995.05020134.x ◽

1995 ◽

Vol 5 (2) ◽

pp. 134-142 ◽

Cited By ~ 11

Author(s):

P.J. Hoskins ◽

K.D. Swenerton ◽

F. Wong ◽

M.F. Manji ◽

E.M. McMurtrie ◽

...

Keyword(s):

Ovarian Cancer ◽

High Risk ◽

Epithelial Ovarian Cancer ◽

Stage I ◽

Stage Iii ◽

Grade 3

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Adjuvant oral alkylating chemotherapy in patients with stage I epithelial ovarian cancer

Cancer ◽

10.1002/1097-0142(19890315)63:6<1070::aid-cncr2820630605>3.0.co;2-f ◽

1989 ◽

Vol 63 (6) ◽

pp. 1070-1073 ◽

Cited By ~ 27

Author(s):

Holly H. Gallion ◽

John R. van Nagell ◽

Elvis S. Donaldson ◽

Robert V. Higgins ◽

Deborah E. Powell ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage I

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Comparison of Primary Tumor Size in Stage I and III Epithelial Ovarian Cancer

Anticancer Research ◽

10.21873/anticanres.13015 ◽

2018 ◽

Vol 38 (11) ◽

pp. 6507-6511 ◽

Cited By ~ 1

Author(s):

EDGAR PETRU ◽

CAROLA HUBER ◽

EVA SAMPL ◽

JOSEF HAAS

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Tumor Size ◽

Primary Tumor ◽

Stage I ◽

Primary Tumor Size

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Clinical Practice of Adjuvant Chemotherapy in Patients with Early-Stage Epithelial Ovarian Cancer

Chemotherapy ◽

10.1159/000445024 ◽

2016 ◽

Vol 61 (6) ◽

pp. 287-294

Author(s):

Lindy M.J. Frielink ◽

Brenda M. Pijlman ◽

Nicole P.M. Ezendam ◽

Johanna M.A. Pijnenborg

Keyword(s):

Ovarian Cancer ◽

Clinical Practice ◽

Adjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Early Stage ◽

Figo Stage ◽

Selective Treatment ◽

Platinum Based Chemotherapy ◽

Grade 3 ◽

Practice Methods

Background: Adjuvant platinum-based chemotherapy improves survival in women with early-stage epithelial ovarian cancer (EOC). Yet, there is a wide variety in clinical practice. Methods: All patients diagnosed with FIGO I and IIa EOC (2006-2010) in the south of the Netherlands were analyzed. The percentage of patients that received adjuvant chemotherapy was determined as well as the comprehensiveness of staging and outcome. Results: Forty percent (54/135) of the patients with early-stage EOC received adjuvant chemotherapy. Treatment with adjuvant chemotherapy was associated with FIGO stage, clear-cell histology and nonoptimal staging. Optimal staging was achieved in 50%, and nonoptimal staging was associated with advanced age, comorbidity and treatment in a non-referral hospital. Overall, there was no difference in outcome between patients with and without adjuvant chemotherapy. Yet, in grade 3 tumors, adjuvant chemotherapy seems beneficial. Conclusions: Selective treatment of patients with early-stage EOC might reduce adjuvant chemotherapy without compromising outcome.

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Transcriptional Characterization of Stage I Epithelial Ovarian Cancer: A Multicentric Study

Cells ◽

10.3390/cells8121554 ◽

2019 ◽

Vol 8 (12) ◽

pp. 1554

Author(s):

Enrica Calura ◽

Matteo Ciciani ◽

Andrea Sambugaro ◽

Lara Paracchini ◽

Giuseppe Benvenuto ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage I ◽

Molecular Heterogeneity ◽

Low Grade ◽

Multicentric Study ◽

Molecular Alterations ◽

Molecular Features ◽

Signaling Axis ◽

Tumor Biopsies

Stage I epithelial ovarian cancer (EOC) represents about 10% of all EOCs. It is characterized by a complex histopathological and molecular heterogeneity, and it is composed of five main histological subtypes (mucinous, endometrioid, clear cell and high, and low grade serous), which have peculiar genetic, molecular, and clinical characteristics. As it occurs less frequently than advanced-stage EOC, its molecular features have not been thoroughly investigated. In this study, using in silico approaches and gene expression data, on a multicentric cohort composed of 208 snap-frozen tumor biopsies, we explored the subtype-specific molecular alterations that regulate tumor aggressiveness in stage I EOC. We found that single genes rather than pathways are responsible for histotype specificities and that a cAMP-PKA-CREB1 signaling axis seems to play a central role in histotype differentiation. Moreover, our results indicate that immune response seems to be, at least in part, involved in histotype differences, as a higher immune-reactive behavior of serous and mucinous samples was observed with respect to other histotypes.

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