# Divergent Survival Outcomes With Adjuvant Chemotherapy in Stage IA Ovarian Clear Cell Carcinoma: Insights From the SEER Database

## TL;DR

This study finds that adjuvant chemotherapy for early-stage ovarian clear cell carcinoma has mixed survival effects depending on the patient's age.

## Contribution

The study reveals age-dependent divergent outcomes of adjuvant chemotherapy in Stage IA ovarian clear cell carcinoma patients.

## Key findings

- Chemotherapy was linked to worse survival in patients aged ≤ 50 years.
- Older patients (> 70 years) experienced improved survival with chemotherapy.
- Multivariate analysis showed chemotherapy had little overall impact on survival.

## Abstract

This study aims to evaluate the impact of adjuvant chemotherapy on cancer-specific survival (CSS) and overall survival (OS) in patients with Stage IA ovarian clear cell carcinoma (OCCC) using data from the Surveillance, Epidemiology, and End Results (SEER) database.

We conducted a retrospective cohort study utilizing SEER data (2000–2021) to compare the prognosis of Stage IA OCCC patients who received adjuvant chemotherapy versus those who did not. Propensity score matching (PSM) was used to balance baseline characteristics between the groups. Competing risks regression and multivariate Cox regression analyses identified prognostic factors for CSS and OS.

A total of 1422 Stage IA OCCC patients were identified. After PSM, 776 patients (388 in each group) were included. For patients aged ≤ 50 years, chemotherapy was linked to worse CSS (89.5% vs. 96.2%, p=0.007) and OS (89.3% vs. 95.9%, p=0.008). Conversely, in patients aged > 70 years, chemotherapy was associated with improved CSS (93.0% vs. 81.9%, p=0.038) and OS (86.0% vs. 72.4%, p=0.006). These trends remained after PSM. Multivariate analysis showed that chemotherapy had little impact on OS and CSS. Subgroup analysis further indicated that chemotherapy negatively affected CSS and OS in patients aged ≤ 50 years.

Adjuvant chemotherapy did not significantly improve survival outcomes in patients with Stage IA OCCC. However, its effects were age-dependent, with older patients (> 70 years) experiencing improved survival, while younger patients (≤ 50 years) exhibited worse outcomes. These findings underscore the importance of individualized treatment strategies for Stage IA OCCC.