Survival impact of capsule rupture in stage i clear cell carcinoma of the ovary in comparison with other histological types

Makiko Higashi, Hiroaki Kajiyama, Kiyosumi Shibata, Mika Mizuno, Kimio Mizuno, Satoyo Hosono, Michiyasu Kawai, Toru Nakanishi, Tetsuro Nagasaka, Fumitaka Kikkawa

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45 Citations (Scopus)


Objective: We analyzed a large number of stage I clear cell carcinoma of the ovary (CCC) patients to estimate the survival impact of the capsule status in stage I CCC patients, particularly in comparison with non-CCC patients. Methods: Clinicopathologic data on 564 patients with stage I epithelial ovarian cancer (EOC) collected under the central pathological review system were subjected to uni- and multivariable analyses to evaluate the disease-free survival (DFS) and overall survival (OS). Results: There was no significant difference in both the OS and DFS of CCC patients between IA and IC(ir) (intraoperative capsule rupture) {IA vs. IC(ir); OS: P = 0.1402, DFS: P = 0.2701}. In contrast, CCC patients at IC(non-ir) {IC excluding for IC(ir), such as preoperative capsule rupture, positive ascites/washing, and surface involvement} showed a poorer OS and DFS than those at IC(ir), or those at the corresponding stage in non-CCC. In multivariable analysis, the capsule status was an independent prognostic factor of a poor OS and DFS {OS: HR, 2.832; 95% CI 1.156-6.938; P = 0.023; DFS: HR, 4.327; 95% CI, 1.937-9.667; P = 0.0004)} {In contrast, non-CCC: N.S. (OS/DFS)}. Furthermore, in CCC patients, intraperitoneal recurrences were more frequently observed in IC(non-ir) CCC than IA or IC(ir) CCC (P = 0.0083) {In contrast, non-CCC: N.S.}. Conclusion This study suggests that CCC patients other than those with intraoperative capsule rupture show a considerable risk for mortality despite adjuvant chemotherapy.

Original languageEnglish
Pages (from-to)474-478
Number of pages5
JournalGynecologic oncology
Issue number3
Publication statusPublished - 12-2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynaecology


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