KEY TAKEAWAYS
- The study aimed to investigate the prognostic differences and potential risk markers between patients with advanced OCCC and OSC.
- Researchers noticed that advanced OCCC and OCCC with liver metastases as high-risk, with a nomogram predicting survival effectively and GPC3 showing therapeutic potential.
Ovarian clear cell carcinoma (OCCC) is a rare pathological histotype in ovarian cancer (OC), while the survival rate of advanced OCCC (Stage III-IV) is substantially lower than that of the advanced serous ovarian cancer (OSC), which is the most common histotype.
Tingwei Liu and the team aimed to identify high-risk OCCC by comparing OSC and OCCC, with investigating potential risk and prognosis markers.
They performed an inclusive analysis of patients diagnosed with OC from 2009 to 2018, identified from the Surveillance, Epidemiology, and End Results (SEER) Program. Logistic and Cox regression models were used to identify risk and prognostic factors in high-risk OCCC patients. Cancer-specific survival (CSS) and overall survival (OS) were assessed using Kaplan-Meier curves.
Furthermore, Cox analysis was employed to build a nomogram model. The performance evaluation results were displayed using the C-index, calibration plots, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). An immunohistochemical approach was used to identify the expression of the novel target, GPC3.
In the Cox analysis for advanced OCCC, age (45-65 years), tumor numbers (total number of in situ/malignant tumors for patient), T3-stage, bilateral tumors, and liver metastases could be defined as prognostic variables. The nomogram showed good predictive power and clinical practicality. Compared with OSC, liver metastases had a stronger impact on the prognosis of patients with OCCC.
T3-stage, positive distant lymph node metastases and lung metastases were risk factors for developing liver metastases. Chemotherapy was an independent prognostic factor for patients with advanced OCCC but had no effect on CSS in patients with liver metastases (P = 0.0656), while surgery was significantly related to better CSS in these patients (P < 0.0001) (P = 0.0041). GPC3 expression was detected in all tissue sections, and GPC3 staining was predominantly found in the cytoplasm and membranes.
The study concluded that advanced OCCC and OCCC with liver metastases are two types of high-risk OCCC. The constructed nomogram exhibited a satisfactory survival prediction for patients with advanced OCCC. GPC3 immunohistochemistry is expected to accumulate preclinical evidence to support the inclusion of GPC3 in OCCC-targeted therapy.
This study was funded by the Natural Science Foundation of Shanghai, the Shanghai Science and Technology Planning Project, the Clinical Science and Technology Innovation Project of Shanghai Shenkang Hospital Development Center, and the National Natural Science Foundation of China.
Source: https://pubmed.ncbi.nlm.nih.gov/38824600/
Liu T, Gao Y, Li S, et al. (2024). “Exploration and prognostic analysis of two types of high-risk ovarian cancers: clear cell vs. serous carcinoma: a population-based study.” J Ovarian Res. 2024 Jun 1;17(1):119. doi: 10.1186/s13048-024-01435-y. PMID: 38824600; PMCID: PMC11143660.
