Observational studyObstetrics and gynecology2019
Intraoperative Capsule Rupture, Postoperative Chemotherapy, and Survival of Women With Stage I Epithelial Ovarian Cancer.
Observational study in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Is There a Survival Benefit of Adjuvant Chemotherapy in Stage IC1 Epithelial Ovarian Cancer Patients? A Meta-Analysis.Current oncology (Toronto, Ont.) · 2022Pooled it
- The post-progression survival of patients with recurrent or persistent ovarian clear cell carcinoma: results from a randomized phase III study in JGOG3017/GCIG.Journal of gynecologic oncology · 2020Trial
- Transvaginal sonography-guided aspiration of benign ovarian cysts: a retrospective evaluation of safety, feasibility, and economic and environmental implications.Archives of gynecology and obstetrics · 2026Article
- Evaluating Performance of a Deep Learning-based Artificial Intelligence Model for Ovarian Tumor Classification Using a Multicenter CT Dataset.Radiology. Imaging cancer · 2026Article
- Oncologic outcomes and predictors of recurrence following minimally invasive and open surgery for thymoma.Journal of thoracic disease · 2025Article
- Mucinous Ovarian Carcinoma: Integrating Molecular Stratification into Surgical and Therapeutic Management.Biomedicines · 2025Review
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- Article
- Review
- Management of patients with early-stage ovarian clear cell carcinoma: risk stratification and fertility conservation.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2022Article
- Laparoscopic Surgery for Ovarian Neoplasms - What is Possible, What is Useful?Geburtshilfe und Frauenheilkunde · 2022Article
- Clear Cell Borderline Ovarian Tumor: Clinical Characteristics, Prognosis, and Management.Annals of surgical oncology · 2022Article
- Adjuvant Chemotherapy May Not Be Necessary for Women with Stage IC1 Epithelial Ovarian Cancer.Current medical science · 2022Article
- Laparoscopic and Laparotomic Restaging in Patients With Apparent Stage I Epithelial Ovarian Cancer: A Comparison of Surgical and Oncological Outcomes.Frontiers in oncology · 2022Article
- Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study.Journal of gynecologic oncology · 2022Article
- Comparison of Laparoscopic and Open Surgery for Women With Early-Stage Epithelial Ovarian Cancer.Frontiers in oncology · 2022Article
- Complications in laparoscopic and robotic-assisted surgery: definitions, classifications, incidence and risk factors - an up-to-date review.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021Review
- Impact of incomplete surgery and adjuvant chemotherapy for the intraoperative rupture of capsulated stage I epithelial ovarian cancer: a multi-institutional study with an in-depth subgroup analysis.Journal of gynecologic oncology · 2021Article
- A large-scale multi-institutional study evaluating prognostic aspects of positive ascites cytology and effects of therapeutic interventions in epithelial ovarian cancer.Scientific reports · 2021Article
- Expression profiles and prognostic values of BolA family members in ovarian cancer.Journal of ovarian research · 2021Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the incidence and prognostic effects of intraoperative capsule rupture and to assess the effectiveness of postoperative chemotherapy for intraoperative tumor rupture in apparent stage I epithelial ovarian cancer.
methodsThis is a society-based retrospective observational study in Japan that examined 15,163 women with stage IA-IC1 epithelial ovarian cancer who underwent primary surgical treatment between 2002 and 2015. Associations between intraoperative capsule rupture and cause-specific survival, and between postoperative chemotherapy and cause-specific survival among intraoperatively ruptured cases were examined by histology type (clear cell n=6,107, endometrioid n=3,910, mucinous n=3,382, and serous n=1,764).
resultsClear cell histology had the highest risk of intraoperative capsule rupture (57.3%), followed by endometrioid (48.8%), serous (41.8%), and mucinous (32.0%) histologies (P<.001). On multivariable analysis, clear cell type exhibited the largest effect of intraoperative capsule rupture on cause-specific survival (adjusted hazard ratio [HR] 1.99, 95% CI 1.45-2.75), followed by serous (adjusted HR, 1.61, 95% CI 0.84-3.11), mucinous (adjusted HR 1.28, 95% CI 0.79-2.09), and endometrioid (adjusted HR, 1.14, 95% CI 0.64-2.01) tumors. Postoperative chemotherapy for intraoperatively ruptured cases did not improve cause-specific survival in any histologic types in multivariable analysis: clear cell, adjusted HR 0.86, 95% CI 0.56-1.31; serous, adjusted HR 1.08, 95% CI 0.42-2.74; mucinous, adjusted HR 1.11, 95% CI 0.55-2.27; and endometrioid, adjusted HR 2.81, 95% CI 0.85-9.30 (all, P>.05). In the cohort-level analysis of ruptured cases (n=7,227), postoperative chemotherapy use has significantly decreased in mucinous (16.3% relative decrease), endometrioid (13.1% relative decrease), and clear cell (9.3% relative decrease) (all, P<.05); but, the cohort-level 5-year cause-specific survival rate did not change over time (all, P>.05).
conclusionAmong apparent stage I epithelial ovarian cancer, the clear cell type possesses a disproportionally high risk of capsule rupture during adnexectomy and is associated with the most adverse effect on survival. A decrease in the use of postoperative chemotherapy for intraoperatively ruptured cases in Japan is likely the result of increasing awareness of the absence of survival benefits.
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