Comparison and analysis of the clinicopathological features of SCEO and ECOM

Abstract

ObjectiveThe aim of our study was to evaluate and compare the differences in the clinicopathological variables and overall survival (OS) of synchronous primary cancers of the endometrium and ovary (SCEO) and endometrial cancer with ovarian metastasis (ECOM). In addition, we aimed to determine the characteristics of and effective treatments for patients with SCEO to avoid misdiagnosis and overtreatment.Materials and methodsA review of medical records from January 2009 to January 2017 revealed 111 patients with coexisting ovarian and endometrial carcinoma diagnosed at the Obstetrics and Gynecology Hospital of Fudan University. Clinicopathological variables were analysed using the Chi square test and Student’s t test. The survival rate was estimated using the Kaplan-Meier method, and statistical significance was analysed using the logarithmic rank test (univariate analysis).ResultsThere were 51 cases of SCEO and 60 cases of ECOM. The mean age at diagnosis was 53.96 years and 55.41 years, respectively. There were no differences in age, menopausal status, BMI, CA125 level or complaints between the two groups. The 5-year survival rates were 58.8 and 36.7%, respectively (P < 0.001). Significant differences were found in the endometrial tumour classification, ovarian cancer stage, and lymph node and omentum metastasis between SCEO and ECOM.ConclusionsThe differences found between SCEO and ECOM are of great clinical significance. Our results reveal useful prognostic and clinicopathological features. More aggressive therapies should be administered to both SCEO and ECOM patients, especially elderly patients and those with menopause, endometrial tumours, advanced omentum metastasis, and lymph node dissection.

Synchronous endometrial and ovarian carcinoma (SEOC): case series and literature review

“…In our cohort of patients, the results and treatment outcome was different from available literature on SEOCs, and this poses a question of clinical and pathologic importance. Currently, the histologic diagnosis of a synchronous tumour is according to the Ulbright and Roth criteria for SEOC [14,15]. These criteria, however, may not always be applicable.…”

“…In our case series, molecular and IHC testing would play a significant role in determining metastatic disease or SEOC, which would enable us to recommend appropriate counselling and adjuvant treatment. A recent study by Wang T et al [14] suggested that aggressive therapy to both SEOC, endometrial carcinoma and ovarian metastasis (ECOM) patients, especially those with menopausal status, endometrial tumours, advanced omental and lymph node metastasis for better prognosis and survival rate.…”

Elevated CA-125 Level and ER-Negative as Prognostic Factors for Ovarian Metastasis in Patients with Endometrial Cancer: A Retrospective Cohort Study

“…Previously studies have reported that the incidence of metastatic ovarian cancer and coexisting malignancies in endometrial cancer varies from 5% to 29%, which may be due to sample size, cancer characteristics, ethnic group, and different pathological diagnostic criteria [ 5 – 10 ]. Lee et al found that it is possible to preserve ovaries in young women with early-stage endometrial carcinoma with a thorough and extensive intraoperative exploration, and only 2 out of 206 (0.97%) patients without a visible extra-uterine lesion detected during surgery had ovarian cancer [ 6 ].…”

“…Some reports have demonstrated that preservation of the ovaries is safe in patients with early-stage EC [ 4 ]. However, the incidence of metastatic ovarian cancer and coexisting malignancies in endometrial cancer varies from 5% to 29% [ 5 – 10 ]. Therefore, the decision to preserve the ovaries must be carefully considered.…”

Synchronous Primary Endometrium and Ovarian Carcinoma: A Case Report

“…4 As the incidence of synchronous primary endometrial and ovarian carcinoma (SPEOC) is limited, it can easily be confused with endometrial cancer with ovarian metastasis. 5 Thus, it is often challenging to diagnose such separate independent primary tumors and mandates careful consideration of a number of lesions, histological and immunohistochemical features as the two entities have different therapeutic and prognostic implications. 6 We report a case of a 38-year woman with an endometrioid variant of synchronous primary endometrial and left ovarian carcinoma.…”