| Objective:By assessing the clinical characteristics,clinical outcomes,and long-term prognostic outcomes among patients with primary ovarian clear cell carcinoma(OCCC),and exploring the related prognostic risk factors of OCCC,and providing other supporting evidence,in order to provide assistance in the clinical diagnosis and management of OCCC,and further improve the diagnosis accuracy of OCCC and help to select the most appropriate treatment,and eventually benefit the prognostic outcomes of OCCC.Methods:We included 86 eligible cases with primary OCCC based on the inclusion and exclusion criteria treated in the Provincial Hospital Affiliated to Anhui Medical University between January 2010 and March 2020.We collected data from previous medical records and we collected prognostic information such as survival and recurrence through outpatient follow-up records as well as contacting patients by internet and telephone.On the other hand,179 eligible cases of OCCC were collected to analyze through the Surveillance,Epidemiology and End Results(SEER)database for analysis.Results:(1)Our study included 86 eligible OCCC patients with an average age of 49.21±9.91 years old,of which 74.42% were at early stage and 25.58% were at advanced stage.The average preoperative CA125 was 601.48 IU/m L.Sixteen patients had endometriosis,and 8 patients had venous thromboembolism.(2)64 patients underwent staging surgery and 22 patients underwent primary cytoreduction.4.55% of 66 patients who underwent lymphadenectomy had lymph node involvement.In terms of immunohistochemistry,55%(11/20)of patients were positive for hepatocyte nuclear factor 1β(HNF1β),and negative for Wilms Tumor 1(WT-1),estrogen receptor(ER)and progesterone receptor(PR).Among patients with advanced OCCC,77.27% of them had optimal cytoreduction.(3)The 3-year progression-free survival(PFS)rate of early and advanced patients were 78.95% and 22.22%,on the other hand,the 3-year overall survival(OS)rate were 89.47% and 44.44%,respectively.CA19-9(P=0.038),advanced stage(P=0.001)and ascites(≥2000m L)(P=0.015)were significantly related to the decreased OS,age(P=0.038)and advanced tumor(P=0.002)were significantly related to the decreased PFS.CA19-9(P=0.025)and ascites(≥2000m L)(P=0.001)are also independent prognostic indicators of OS,and HE4(P=0.027)and ascites(≥2000m L)(P=0.001)are independent prognostic indicators of PFS.(4)The 3-year OS rate of 179 OCCC patients from the SEER database was 56.98%.AJCC(American Joint Committee on Cancer)staging(P<0.001),SEER staging(P<0.001),the number of lymph nodes removed ≥4(P=0.003)and lymph node metastasis(P<0.001)were significantly related to the OS of OCCC patients,and lymph node metastasis was an Independent risk factors for prognosis for the OS of OCCC(P=0.001).Conclusions:(1)Most OCCC patients are at young age and early stages at the time of diagnosis,with mildly elevated CA125 levels.OCCC patients are more prone to thrombosis.(2)Positive expression of HNF1β,and negative expression of WT-1,ER and PR are reliable immunohistochemical indicators for differential diagnosis of OCCC.(3)Patients with early stage OCCC have a better prognosis than advanced-stage patients.CA19-9,HE4,ascites(≥2000ml)and positive lymph node metastasis are Independent risk factors for prognosis. |
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