Prognostic Impact of an Adenofibromatous Component in Stage I Ovarian Clear Cell Adenocarcinoma
Kyoko Nishikimi, Takako Kiyokawa, Shinichi Tate, Makio Shozu. Chiba University School of Medicine, Chiba, Japan
Background: Ovarian clear cell adenocarcinoma (CCA) is frequently associated with endometriosis, and less often with an adenofibromatous component (AF). While one study suggested that AF might be a factor for less aggressive behavior, the other study showed contradictory results. We conducted a retrospective study to examine prognostic impact of AF in Stage I CCA.
Design: Eighty-nine cases (age: 32-84yrs, average 54.9yrs) of Stage I CCA surgically treated between 2000 and 2007 were included in the study. All H-E slides of the ovarian tumors were reviewed for the presence of AF and endometriosis associated with carcinoma. The number of low-power (x40) fields (LPF) with AF was counted. Peritoneal cytology at the time of laparotomy was also reviewed. A multivariate Cox proportional hazards model was used to assess the association of potential prognostic factors (AF, endometriosis, peritoneal cytology) with disease-free survival.
Results: Of 89 cases 27 (30.3%) were associated with AF, 54 (60.7%) with endometriosis, and 27 (30.3%) with positive peritoneal cytology. The number of LPF with AF varied between 1-80 (median 5, mean 13). Of 89 cases, 15 (17%) recurred in a follow-up period (range 4.1-111.1 months, median 38.7 months). Multivariate analysis identified that AF >15 LPF was associated with improved disease-free survival (HR=0.23, 95% CI 0.47-1.15, p=0.074), and positive peritoneal cytology with recurrence (HR = 9.05, 95% CI 2.44-33.49, p=0.001), while endometriosis had no prognostic significance (HR = 0.76, 95% CI 0.24-2.38, p=0.63).
Conclusions: Our results suggest that association with AF > 15 LPF may predict favorable prognosis in Stage I CCA.
Category: Gynecologic & Obstetrics
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 145, Tuesday Afternoon