For the patients to receive FSS, randomized study cannot be performed because of ethical aspect. In this review, we summarize the FSS for CCC based on the retrospective studies. Schilder et al. demonstrated that no recurrence was observed among 5 patients with stage IC CCC who received FFS; however, the detail of stage or postoperative chemotherapy was not Proteases inhibitor recorded [23]. Kajiyama et al. reported the clinical outcome of 10 patients with stage I CCC treated with FSS (IA:4, IC(intraoperative capsule rupture): 5, selleck screening library IC(positive for malignant ascites):1) and demonstrated as follow [24]: (1) Among
10 patients, 9 patients received chemotherapy after surgery, (2) one patient with IC(positive for
malignant ascites) who received postoperative chemotherapy recurred. Sato et al. reported 30 patients with stage I CCC who received FFS and reported as follow [25]: (1) Among 15 IA cases, 9 cases received chemotherapy after surgery and no one recurred, (2)Among 15 IC patients, 11 patients received chemotherapy after surgery, and 2 patients (IC(intraoperative capsule rupture):2) recurred among 11 patients who received chemotherapy and 3 patients (IC(intraoperative capsule rupture):2, IC(positive for malignant ascites or surface capsule involvement):1) recurred among 4 patients who did not received chemotherapy. (3) Recurrent sites are residual ovary (n = 3), lymph node (n = 2), peritoneum (n = 2) and liver (n = 1). (4) The 5-year survival rate is 93.3%. These data are shown Autophagy inhibitor in Table 2. Table 2 Relapse rates of clear cell carcinoma patients who received FSS stage author year number of patients relapse Stage IA Kajiyama
[23] 2008 4 0% (0/4) Satoh [24] 2010 15 0% (0/15) before total 19 0% (0/19) Stage IC Schilder [22] 2001 5 0% (0/5) Kajiyama [23] 2008 6 17% (1/6) Satoh [24] 2010 15 33% (5/15) total 26 23% (6/26) We summarized Kajiyama’s and Sato’s reports in detail: (1) Among 19 patients, 12 patients received postoperative chemotherapy and no one recurred. (2) Among 21 IC patients, 17 patients received postoperative chemotherapy, and recurrent rate of IC(intraoperative capsule rupture) and IC(positive for malignant ascites or surface capsule involvement) are 25%(4/16) and 40%(2/5). (3) Among 17 IC patients who received postoperative chemotherapy, 3 (18%) patients recurred and among 4 IC patients who did not received chemotherapy, 3 (75%) patients recurred. Recently, Kajiyama et al. also analyzed the OS of 16 patients with stage I CCC who underwent FSS and compared survival with 204 patients receiving radical surgery, or 64 patients with non-CCC undergoing FSS and demonstrated that patients with CCC who underwent FSS did not show a poorer survival than non-CCC patients who underwent FSS, or those at the corresponding stage with no CCC [26].