Predicting Behavior in Ovarian Clear Cell Carcinoma: Are We There yet?
Elizabeth D Euscher, Anais Malpica. University of Texas MD Anderson Cancer Center, Houston, TX
Background: Ovarian clear cell carcinoma (OCCC) is typically not graded although is considered a high grade malignancy. Attempts have been made to link various histopathologic parameters such as endometriosis and the presence of adenofibromatous component to outcome. Recently, some investigators have proposed a grading system based on the architectural pattern of the tumor. In this study, we evaluate the performance of this grading system as well as other histopathologic features as predictors of outcome in a consecutive series of OCCC.
Design: A search of the pathology database from 2002-2007 yielded 68 cases of OCCC with follow up. Mixed epithelial carcinomas containing OCCC were excluded. The following parameters were recorded: pt age; stage; tumor size; presence/absence of endometriosis in the tumor or elsewhere; presence absence of adenofibromatous component; %solid component; presence/absence of single cell invasion; number of mitoses (4 sets of 10 high power fields counted with highest mitotic index (MI) selected); patient outcome.
Results: Pt ages ranged from 29-68yr (median 51). Tumor stage was known in 66 pts: I, 28; II, 16; III, 22. 5-135 mo (median 50) follow up was available: dead of disease, 38pts; alive with disease, 9pts; no evidence of disease at last follow up, 21pts. 15/21pts did not experience recurrence. Percent solid component ranged from 0-80% for all tumors with a median of 10 for pts with and without recurrence. Remaining pathologic features of pts who died of disease or recurred and those who did not recur are presented in Table 1.
|Stage I||Tumor size (median cm)||Endometriosis Present||Adenofibroma Present||>10% Solid Component||Single Cells Present||MI|
|All Cases (n=68)||28 (41%)||12||37 (54%)||9||30 (44%)||19 (28%)||5|
|Dead of Disease or Recurred (n=53)||18 (34%)||13.5||27 (51%)||7||23 (43%)||18 (34%)||5|
|No Evidence of Disease/No Recurrence (n=15)||10 (66%)||10||10 (66%)||2||7 (47%)||1 (6.6%)||4|