The majority of ovarian cancer patients are diagnosed with serous carcinomas (80-85%) and these tumours have a high response rate to platinum-based chemotherapy.73 While one sub-set analysis in the ACTION trial showed improved overall survival for women with early-stage ovarian cancer within the chemotherapy arm, for those with serous carcinoma compared with clear-cell carcinoma (p= 0.04), the differences disappeared when optimal staging was taken into account.83 The sub-set analysis also showed adjuvant chemotherapy significantly improved disease-free survival for women with serous ovarian cancer but there was no significant improvement for women with clear-cell ovarian cancer.
Analysis of data from four randomised phase III and one phase II first-line trials (GINECO database) indicated that women with mucinous ovarian cancer receiving carboplatin-paclitaxel based chemotherapy had significantly lower overall response (complete and partial) (p<0.001), shorter overall survival and shorter progression-free survival than women who had serous ovarian cancer.84