Clinical Features and Establishment of a Recurrence Prediction Model in Early Ovarian Clear Cell Carcinoma Patients

Purpose This study aims to summarize the clinical characteristics of early-stage ovarian clear cell carcinoma (OCCC) patients and establish a predictive model for recurrence. Methods A retrospective analysis was conducted on clinical, pathological, and prognostic data of 129 early-stage OCCC patients treated at Peking University Third Hospital from January 2010 to June 2023. Clinical and pathological features of these patients were compared and summarized. Prognostic factors related to recurrence were explored, and a recurrence prediction model was established through nomogram. Results The average age of patients was 54.38±8.66 years, with 110 cases (85.2%) in Stage I. The majority underwent comprehensive staging surgery (124 cases). Most patients exhibited positive expressions of NapsinA (92%) and HNF1β (98.9%). Immunohistochemical features were consistent with OCCC diagnosis, with negative expressions of ER (81.3%), PR (86%), and WT1 (94.2%). Among the 129 patients, 18 experienced recurrence, and 5 were lost to follow-up. The median progression-free survival (PFS) for recurrent patients was 16.5 months (range: 3-59 months). Significant prognostic factors associated with PFS were identified through univariate and multivariate analyses, including tumor FIGO stage, preoperative lower limb thrombosis, comprehensive staging surgery, age at diagnosis, parity, and menopausal status. A nomogram was constructed based on these variables to establish a recurrence prediction model. The AUC values for predicting the 1-year, 3-year, and 5-year recurrence were 0.831, 0.765, and 0.759, respectively, all exceeding 0.5. Conclusion This study provides a comprehensive summary of the clinical and pathological characteristics of early-stage OCCC patients, explores prognostic factors related to recurrence and establishes a reliable recurrence prediction model. The model may serve as a reference for clinical counseling, treatment decision-making, and follow-up of early-stage patients who desire fertility sparing.