Title | Distribution and case-fatality ratios by cell-type for ovarian carcinomas: a 22-year series of 562 patients with uniform current histological classification. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Seidman JD, Vang R, Ronnett BM, Yemelyanova A, Cosin JA |
Journal | Gynecol Oncol |
Volume | 136 |
Issue | 2 |
Pagination | 336-40 |
Date Published | 2015 Feb |
ISSN | 1095-6859 |
Keywords | Cohort Studies, Female, Humans, Mortality, Neoplasm Grading, Neoplasm Staging, Ovarian Neoplasms, Survival Analysis |
Abstract | BACKGROUND: Ovarian carcinoma is comprised of several different cell types reflecting different clinicopathologic features. Pathologic criteria for distinguishing cell types have evolved, and therefore non-contemporary literature on ovarian cancer may have limited current relevance. A new dualistic model of pathogenesis that distinguishes type I (endometrioid, mucinous, clear cell and low grade serous carcinomas) from type II (high grade serous carcinomas and carcinosarcomas) tumors has become widely accepted. METHODS: A cohort of 562 patients with invasive ovarian carcinoma from a large community hospital practice was reviewed. Cell type, FIGO stage, mortality and interpathologist diagnostic reproducibility were analyzed. RESULTS: Advanced stage ovarian carcinomas were type II in 86% of cases while low stage tumors were most often type I. Only 1.7% of type II tumors were confirmed to be stage I with comprehensive surgical staging. Type II tumors accounted for 85% of deaths, and clear cell carcinomas, 5% of deaths. Cell type-specific case-fatality ratios for type II tumors were 62% and 79% for high grade serous carcinoma and carcinosarcoma, respectively. For type I tumors, case-fatality ratios were 38%, 36%, 27% and 13% for low grade serous, clear cell, endometrioid and mucinous carcinomas, respectively. The kappa value for diagnostic reproducibility among 3 gynecologic pathologists was 0.83. CONCLUSIONS: Current diagnostic criteria confirm that high grade serous carcinoma and carcinosarcoma account for the vast majority (85%) of ovarian cancer deaths. Cell type designation is highly reproducible among gynecologic pathologists. Type II tumors are rarely stage I (<2%) when comprehensively staged by a gynecologic oncologist. |
DOI | 10.1016/j.ygyno.2014.12.018 |
Alternate Journal | Gynecol Oncol |
PubMed ID | 25528497 |
Related Faculty:
Anna Yemelyanova, M.D.