Surgical and medical treatment of clear cell ovarian cancer, results from the multicenter italian trials in ovarian cancer (MITO) 9 retrospective study

Francescapaola Magazzino, Dionyssios Katsaros, Alessandro Ottaiano, Angiolo Gadducci, Carmela Pisano, Roberto Sorio, Emanuela Rabaiotti, Giovanni Scambia, Gennaro Cormio, Luca Scarampi, Stefano Greggi, Antonella Savarese, Marco Marinaccio, Paolo Scollo, Sandro Pignata

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Objective: Clear cell ovarian carcinoma has a poorer prognosis compared with other histological subtypes. Materials and Methods: The Multicenter Italian Trials in Ovarian Cancer (MITO) 9 study retrospectively assessed an Italian cohort of patients with clear cell ovarian cancer observed in the years 1991-2007 in 20 Italian centers. Results: A total of 240 patients with ovarian cancer were analyzed. Forty-five percent of the patients had stage I disease. In 62.9%, clear cell histology was pure, whereas in the other cases, a mixed population was evident. Most of the cases underwent standard surgery, whereas in 7.1% of the patients, a fertility-sparing surgery was given. Lymphadenectomy was performed in 47.9%(115/240) of the patients (54.3%in stages I and II; 39.2%in advanced stage). Most of the patients were treated with platinum-based chemotherapy including paclitaxel in 52.9%. Disease-free survival was longer in patients undergoing lymphadenectomy at surgery (P = 0.0001), both in early stages (P = 0.0258) and in stage III and IV diseases (P = 0.0037). The impact of lymphadenectomy was also evident on overall survival in patients with advanced-stage disease. At multivariate analysis, lymphadenectomy (done vs not done) and stage (I and II vs III and IV) were independently associated with longer disease-free and overall survival, whereas front-line chemotherapy (with vs without taxanes) was not significant. Conclusion: This analysis suggests that lymphadenectomy has a strong prognostic role for clear cell ovarian cancer influencing disease-free survival and overall survival. The addition of paclitaxel to platinum-based chemotherapy does not affect the outcome.

Original languageEnglish
Pages (from-to)1063-1070
Number of pages8
JournalInternational Journal of Gynecological Cancer
Issue number6
Publication statusPublished - Aug 2011


  • Chemotherapy
  • Clear cell
  • Lymphadenectomy
  • Ovarian carcinoma

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology


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