Ovarian clear cell carcinoma (OCCC) is a rare subtype of epithelial ovarian carcinoma with poor prognosis in advanced stages and recurrent disease. Recent literature on outcomes in clinical practice for OCCC including advanced stage (stage III and IV) is limited.
A retrospective review of patients with OCCC treated at The Royal Marsden between March 2003 and July 2022 was conducted. Demographic and clinicopathologic factors were abstracted and evaluated using Kaplan-Meier analyses.
184 evaluable patients were identified (median follow up time 37.5 months). Median age was 53.7 (range 30.6-79.6). The FIGO stage distribution at diagnosis was: I 81/184 (44%); II 37/184 (20%); III 58/184 (32%) and IV 8/184 (4%). 169/184 (92%) received adjuvant chemotherapy, whereas 5/184 patients (3%) had adjuvant radiotherapy. 56 patients (30%) were treated within clinical trials. 117/184 (64%) developed disease relapse (61/117 (52%) and 56/117 (48%) had early and advanced disease at diagnosis, respectively). The median time from first recurrence to death was 14.7 (range 0-123.1) months. For patients with stage III/IV disease at diagnosis, median progression free survival from last platinum treatment was 23.1 (95% CI 13.8-32.3) and 18.3 months (95% CI 8.3-24.4) for stage III and IV, respectively. Median overall survival was 131.3 (95% CI 54.1-208.5), 79.5 (95% CI 31.1-127.9), 24.2 (95% CI 5.4-43) and 22.4 (95% CI 11.9-32.8) months for stage I, II, III and IV respectively. Time to progression among patients with recurrent disease treated with radiotherapy (n=19, 10%), Bevacizumab (n=12, 7%) and immunotherapy (n=14, 8%) was 10.2, 6.6 and 6.9 months, respectively.
We report a large, single centre retrospective series of OCCC outcomes in clinical practice in an era of novel therapies and clinical trials. Survival remains poor for advanced/recurrent OCCC and improved treatment strategies are urgently needed.