Prognostic impact of interleukin-6 expression in stage I ovarian clear cell carcinoma

Gynecol Oncol. 2017 Sep;146(3):609-614. doi: 10.1016/j.ygyno.2017.06.027. Epub 2017 Jun 30.


Objective: Ovarian clear cell carcinoma (OCCC) frequently presents at an early stage. In stage I OCCC, the prognosis differs according to substage. In particular, predictive biomarkers and new treatment strategies are needed for stage IC2/IC3 disease. We investigated tumor biology and prognostic factors for stage I OCCC from a clinicopathological perspective, including the expression of ARID1A and IL-6, which are considered critical for OCCC carcinogenesis.

Methods: A retrospective cohort study of 192 patients with stage I OCCC treated at a single institution was performed. We calculated overall survival (OS) with respect to 12 clinicopathological parameters that included the unique and diverse histological features of OCCC.

Results: The estimated 5-year OS rate in patients with all stage I OCCC was 88.9% during a median of 91months of follow-up. The multivariate analysis indicated that substage classification and IL-6 expression status were associated with poor OS (p=0.010 and p=0.027, respectively). Loss of ARID1A expression had no impact on survival; however, it was associated with substage (p=0.001), capsule rupture status (p=0.011), and ascites cytology (p=0.016). No clear association was found between ARID1A and IL-6 expressions. Histological findings, including the presence of endometriosis, adenofibroma, architectural pattern, and tumor cell type, showed no prognostic effects.

Conclusions: Both substage classification and IL-6 expression status may be independent prognostic factors in stage I OCCC. Therefore, IL-6 molecular stratification may be crucial in optimizing therapeutic strategies for early stage OCCC to improve survival.

Keywords: ARID1A; Interleukin-6; Ovarian clear cell carcinoma; Prognosis; Stage I; Substage.

MeSH terms

  • Adenocarcinoma, Clear Cell / chemistry*
  • Adenocarcinoma, Clear Cell / pathology*
  • Adenocarcinoma, Clear Cell / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Ascites / pathology
  • Biomarkers, Tumor / analysis
  • DNA-Binding Proteins
  • Female
  • Humans
  • Interleukin-6 / analysis*
  • Middle Aged
  • Neoplasm Staging
  • Nuclear Proteins / analysis
  • Ovarian Neoplasms / chemistry*
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / therapy
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Transcription Factors / analysis


  • ARID1A protein, human
  • Biomarkers, Tumor
  • DNA-Binding Proteins
  • Interleukin-6
  • Nuclear Proteins
  • Transcription Factors