Clinicopathological Characterstics and Survival Analysis of Clear Cell Carcinoma Endometrium: A Single Institution Experience of Tertiary Cancer Centre in India

Résumé du livre

Introduction:Clear cell carcinoma (CCC) comprises a rare yet an aggressive subtype, accounting for less than 5% of all uterine carcinomas. Treatment programs of CCC endometrium at different stages varies yet outcome of this tumor has not improved. Methods: This study presents a single institution experience regarding the clinico-pathological features, treatment strategies outcomes used in CCC endometrium and discuss parameters associated with Recurrence free survival (RFS) and Overall survival (OS). 26 Patients of Endometrial CCC, diagnosed and treated between 2011 and 2018, were reviewed retrospectively. All data related to patientu2019s demographic, clinical, histopathology assessment, adjuvant and survival outcomes was evaluated. RFS, OS were estimated as well as prognostic factors associated with OS were analyzed using Kaplan u2013Meiru2019s, Cox regression analysis.Results:The mean age at diagnosis was 60.1 years. There were 17 (65.38%) patients with pure clear cell carcinoma and 9(34.62%) with mixed histology.The majority were early stage [ FIGO IA n= 8 [30.77%], I B- n= 3[11.54%], FIGO II n= 4[15.38%], FIGO III A n=2 [7.69%], III B-1(3.85%), III C-4(15.38%) FIGO IV B n=4[15.38%].13 Patients received adjuvant platinum and taxane based chemotherapy with radiotherapy in the form of EBRT and /or vaginal brachytherapy. 10 patients received chemotherapy (Including 4 Palliative only). 1 Patient has received only RT, 2 denied the adjuvant treatment.6 (24%) patients died during follow up, 6(24%) develop recurrence (local -1, distant-5). The Mean OFS, RFS were 62.98 and 55.83 months respectively.The median OS for early stage (I, II)- 52 months, whereas for advanced stage- 24 months. The DFS for early stage was 38 months.P value was not significant for correlation between any of HPE findings and survival outcomes.Conclusion:First case series from our country, although sample size is less. Difference in survival outcomes varies, OS is less in early stage (probably due to low sample size and all 4 patients of stage II were died). More studies are needed to define the adjuvant treatment in this rare type of tumor. Adjuvant therapy (both chemo and RT has a role in the management even in early stage.