Is There a Survival Benefit for Patients with Advanced Ovarian Clear Cell Carcinoma Who Complete More Than 6 Cycles of Postoperative Chemotherapy?

PURPOSE: To provide a reference for clinicians, whether patients with advanced ovarian clear cell carcinoma (OCCC) require chemotherapy (CT) for more than 6 cycles after tumor debulking. PATIENTS AND METHODS: A retrospective review was performed on 85 women diagnosed and treated for advanced OCCC. Outcomes of patients who underwent >6 vs ≤6 cycles of CT were analyzed based on clinicopathological factors. RESULTS: Among the 85 patients with advanced OCCC, 47 patients underwent ≤6 cycles of CT, and 38 patients underwent CT for over 6 cycles. Out of these, 49 patients had disease recurrence, and 35 died. The 2-year progression-free survival (PFS) for patients in the two groups was 51.5% and 42.2% (P＞0.05), respectively. The 2-year overall survival (OS) was 59.7% and 64.5%, respectively (P＞0.05), and the difference was not statistically significant. Multivariate analysis showed that residual tumor diameter was an independent risk factor for prognosis (PFS and OS). We divided the patients into three groups according to residual tumor diameter as 0 (R0), ≤1cm (R1), and >1cm (R2). The prognosis of R0 was better than R1 and R2. Further studies found that patients who received postoperative adjuvant chemotherapy for over 6 cycles showed no difference in improved prognosis, regardless of residual tumor diameter. CONCLUSION: Patients with advanced OCCC who received more than 6 courses of adjuvant chemotherapy after surgery did not show improved prognosis. The residual tumor diameter is an independent indicator of prognosis in patients with advanced OCCC. Complete staging improves the prognosis of patients compared to the ideal or non-ideal cytoreductive surgery.