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The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer
Introduction: To examined survival outcome by histological subtypes in de novo stage IV epithelial ovarian cancer (EOC). Methods: Between 2004 and 2015, patients with stage IV EOC were included using the Surveillance, Epidemiology, and End Results program. The effects of histological subtypes on ove...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288295/ https://www.ncbi.nlm.nih.gov/pubmed/30564556 http://dx.doi.org/10.3389/fonc.2018.00577 |
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author | Zhou, Juan Wu, San-Gang Wang, Jun Sun, Jia-Yuan He, Zhen-Yu Jin, Xin Zhang, Wen-Wen |
author_facet | Zhou, Juan Wu, San-Gang Wang, Jun Sun, Jia-Yuan He, Zhen-Yu Jin, Xin Zhang, Wen-Wen |
author_sort | Zhou, Juan |
collection | PubMed |
description | Introduction: To examined survival outcome by histological subtypes in de novo stage IV epithelial ovarian cancer (EOC). Methods: Between 2004 and 2015, patients with stage IV EOC were included using the Surveillance, Epidemiology, and End Results program. The effects of histological subtypes on overall survival (OS) were assessed using Kaplan–Meier and multivariable Cox regression analyses. Results: We identified 5,953 patients including 5,351 (89.9%), 249 (4.2%), 145 (2.4%), and 208 (3.4%) patients with high-grade serous, endometrioid, mucinous, and clear cell subtypes, respectively. The 5-year OS rates were 28.1, 38.6, 14.2, and 18.8% in patients with high-grade serous, endometrioid, mucinous, and 18.8% clear cell subtypes, respectively, (p < 0.001). Multivariate analyses indicated that histological subtype was an independent predictor of OS. Using the high-grade serous subtype as a reference, OS was comparable for the endometrioid subtype (hazard ratio (HR) 0.915, 95% confidence interval) (CI 0.772–1.085, p = 0.305), but significantly lower for mucinous (HR 3.292, 95% CI 2.701–4.011, p < 0.001) and clear cell subtypes (HR 1.820, 95% CI 1.546–2.141, p < 0.001). Patients with no residual tumor had better OS in the high-grade serous and endometrioid subtypes compared to patients with residual tumors. However, the residual tumor size was not a prognostic factor for OS in mucinous and clear cell carcinoma. Conclusions: Our study suggest a markedly mortality rate in patients with stage IV mucinous and clear cell carcinoma, but better survival in patients with high-grade serous and endometrioid subtypes. Aggressive radical surgery to leave no residual disease would improve survival for high-grade serous and endometrioid carcinoma. More studies are needed to assess the value of aggressive radical surgery in patients with mucinous and clear cell subtypes. |
format | Online Article Text |
id | pubmed-6288295 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62882952018-12-18 The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer Zhou, Juan Wu, San-Gang Wang, Jun Sun, Jia-Yuan He, Zhen-Yu Jin, Xin Zhang, Wen-Wen Front Oncol Oncology Introduction: To examined survival outcome by histological subtypes in de novo stage IV epithelial ovarian cancer (EOC). Methods: Between 2004 and 2015, patients with stage IV EOC were included using the Surveillance, Epidemiology, and End Results program. The effects of histological subtypes on overall survival (OS) were assessed using Kaplan–Meier and multivariable Cox regression analyses. Results: We identified 5,953 patients including 5,351 (89.9%), 249 (4.2%), 145 (2.4%), and 208 (3.4%) patients with high-grade serous, endometrioid, mucinous, and clear cell subtypes, respectively. The 5-year OS rates were 28.1, 38.6, 14.2, and 18.8% in patients with high-grade serous, endometrioid, mucinous, and 18.8% clear cell subtypes, respectively, (p < 0.001). Multivariate analyses indicated that histological subtype was an independent predictor of OS. Using the high-grade serous subtype as a reference, OS was comparable for the endometrioid subtype (hazard ratio (HR) 0.915, 95% confidence interval) (CI 0.772–1.085, p = 0.305), but significantly lower for mucinous (HR 3.292, 95% CI 2.701–4.011, p < 0.001) and clear cell subtypes (HR 1.820, 95% CI 1.546–2.141, p < 0.001). Patients with no residual tumor had better OS in the high-grade serous and endometrioid subtypes compared to patients with residual tumors. However, the residual tumor size was not a prognostic factor for OS in mucinous and clear cell carcinoma. Conclusions: Our study suggest a markedly mortality rate in patients with stage IV mucinous and clear cell carcinoma, but better survival in patients with high-grade serous and endometrioid subtypes. Aggressive radical surgery to leave no residual disease would improve survival for high-grade serous and endometrioid carcinoma. More studies are needed to assess the value of aggressive radical surgery in patients with mucinous and clear cell subtypes. Frontiers Media S.A. 2018-12-04 /pmc/articles/PMC6288295/ /pubmed/30564556 http://dx.doi.org/10.3389/fonc.2018.00577 Text en Copyright © 2018 Zhou, Wu, Wang, Sun, He, Jin and Zhang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Zhou, Juan Wu, San-Gang Wang, Jun Sun, Jia-Yuan He, Zhen-Yu Jin, Xin Zhang, Wen-Wen The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer |
title | The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer |
title_full | The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer |
title_fullStr | The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer |
title_full_unstemmed | The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer |
title_short | The Effect of Histological Subtypes on Outcomes of Stage IV Epithelial Ovarian Cancer |
title_sort | effect of histological subtypes on outcomes of stage iv epithelial ovarian cancer |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288295/ https://www.ncbi.nlm.nih.gov/pubmed/30564556 http://dx.doi.org/10.3389/fonc.2018.00577 |
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