Endometriosis is the independent prognostic factor for survival in Chinese patients with epithelial ovarian carcinoma

Abstract

BackgroundClinico-pathological characteristics and possible prognostic factors among women with epithelial ovarian carcinoma (EOC) with or without concurrent endometriosis were explored.MethodWe retrospectively identified 304 patients with EOC treated primarily at Peking Union Medical College Hospital with median follow-up time of 60 months.ResultsOf 304 patients with EOC, concurrent endometriosis was identified in 69 (22.7%). The patients with concurrent endometriosis were younger and more probably post-menopausal at onset, were less likely to have abdominal distension, with significantly lower level of pre-surgery serum Ca125 and less possibility of having the history of tubal ligation. The women with concurrent endometriosis group were more likely to have early stage tumors (88.41% versus 52.77%), receive optimal cytoreductive surgery (92.75% versus 71.06%), and less likely to have lymph node metastasis or to develop platinum resistance disease (7.25% versus 14.89%, and 7.35% versus 20%), when compared with women without coexisting endometriosis. The univariate analysis showed that concurrent endometriosis was a prognostic factor for overall survival (OS) and disease-free survival (DFS), but this association just remained in the DFS by multivariate analysis. Besides, multivariate analysis also showed that FIGO stage, residual disease, chemotherapy cycles, chemotherapy resistance and concomitant hypertension were the independent impact factors of OS for EOC patients; whereas FIGO stage, lymphadenectomy, residual disease, coexisting endometriosis and chemoresistance were independent impact factors of DFS for those patients.ConclusionsEOC patients with concurrent endometriosis showed distinct characteristics and had longer overall survival and disease-free survival when compared with those without endometriosis. Endometriosis was the independent prognostic factor for DFS for patients in this series.

A Review of the Clinical Characteristics and Novel Molecular Subtypes of Endometrioid Ovarian Cancer

“…Recently, an article defined “high-risk” cases as those which share the same mutations present in EOVC and endometriosis, and “low-risk” cases as those not sharing any mutations in endometriosis with the carcinoma ( 30 ). According to the literature, compared with women without endometriosis, women with endometriosis are more likely to be diagnosed with early-stage tumor, with a significantly lower level of serum CA125 before surgery, and are less likely to have lymph node metastasis or to develop platinum resistance disease ( 18 , 31 ). Patients with EOVC arising from endometriosis presented at a lower average age, have a higher percentage of early-stage and lower–grade disease, and are more likely to have no residual disease after primary debulking surgery compared with those without endometriosis, which indicates better survival outcomes ( 32 ).…”

Association Between Endometriosis and Prognosis of Ovarian Cancer: An Updated Meta-Analysis

“…The methodological quality evaluation for the 21 included studies was conducted with reference to NOS, and the results are shown in Table 2 . The NOS scores of the 21 studies ranged from 5 to 8 points, of which 5 points was evaluated for one study ( 23 ), 6 points for five studies ( 21 , 22 , 24 , 33 , 36 ), 7 points for six studies ( 16 , 20 , 25 , 28 , 29 , 31 ) and 8 points for nine studies ( 12 , 15 , 17 , 26 , 27 , 30 , 32 , 34 , 35 ). Overall, the methodological quality of the included studies was moderate.…”

Correlation of Clinicopathological and Prognostic Characteristics between Endometriosis-Associated and Primary Ovarian Cancer

“…However, sample sizes were usually small and the results obtained were inconsistent. Some ndings suggest that ovarian endometrial carcinoma and ovarian clear cell carcinoma are early phases with better prognosis than the two pathological types of primary ovarian cancer [20][21], while other researchers have reported no obvious differences [22][23]. Here, we examined 174 cases of ovarian endometrial carcinoma and clear cell carcinoma, with a median follow-up period of 67 months.…”