Survival outcome of women with synchronous cancers of endometrium and ovary: a 10 year retrospective cohort study

Abstract

ObjectiveSynchronous occurrence of endometrial and ovarian tumors is uncommon, and they affect less than 10% of women with endometrial or ovarian cancers. The aim of this study is to describe the epidemiological and clinical factors; and survival outcomes of women with these cancers.MethodsThis is a retrospective cohort study in a large tertiary institution in Singapore. The sample consists of women with endometrial and epithelial ovarian cancers followed up over a period of 10 years from 2000 to 2009. The epidemiological and clinical factors include age at diagnosis, histology types, grade and stage of disease.ResultsA total of 75 patients with synchronous ovarian and endometrial cancers were identified. However, only 46 patients met the inclusion criteria. The median follow-up was 74 months. The incidence rate for synchronous cancer is 8.7% of all epithelial ovarian cancers and 4.9% of all endometrial cancers diagnosed over this time frame. Mean age at diagnosis was 47.3 years old. The most common presenting symptom was abnormal uterine bleeding (36.9%) and 73.9% had endometrioid histology for both endometrial and ovarian cancers. The majority of the women (78%) presented were at early stages of 1 and 2. There were 6 (13.6%) cases of recurrence and the 5 year cumulative survival rate was at 84%.ConclusionIn our cohort, we found that majority of women afflicted with synchronous cancer of the endometrium and ovary were younger at age of diagnosis, had early stage of cancer and good survival.

Clinicopathologic Analysis With Immunohistochemistry for DNA Mismatch Repair Protein Expression in Synchronous Primary Endometrial and Ovarian Cancers

“…21,22 However, with synchronous primary endometrial and ovarian cancers, the correlation with endometriosis is still controversial because the occurrence of ovarian cancer ranges from 30% to 90%. 2,17,19 Our data strengthen the role of endometriosis as being involved in the pathogenesis for synchronous primary endometrial and ovarian cancers. In addition, our data suggest a relationship between infertility history and the development of synchronous primary endometrial and ovarian cancers because there were 9 patients with a history of infertility, and 6 of these patients had endometriosis.…”

Synchronous Primary Ovarian Mucinous Carcinoma and Endometrioid Endometrial Carcinoma : A rare case report.

“…Zaino R et al reported 86% 5 year survival and 80% 10 year survival [3] . Another report has shown a mean survival of 84% 6 . Yuantaoliu et al reported a mean survival of 109 months and rate of 93.5% in stage I and stageIItumours [7] .Presentation at an early stage may be attributed to the overall good prognosis .…”

“…In a study done by Y Chiang et al done on 23 cases of synchronous ovarian and endometrial tumours 63% showed similar histology [5] . A 10 year study done by Young Kuei Lim et al on 75 patients with synchronous tumours showed 73.9% being endometrioid endometrial cancers and 26.1 % with tumours of different histological type [6] . Yuantaoliu et al reported 43 cases of synchronous tumours of which 30% showed dissimilar histology [7] .There are only a few reports of synchronous endometrial carcinoma with an ovarian carcinoma of mucinous morphology.…”

Reply: Hereditary portion as an initial genetic approach in gynecologic cancer: synchronous tumor of ovary and endometrium

“…The criteria for familial history used in the study should be clearly specified. Therefore, definitive incidence of HNPCC using clinical criteria could be clearly depicted.The proportion of both endometrioid adenocarcinoma in endometrium and ovary were 50% (18/36) and 74% (34/46) from Korea and Singapore, respectively [3,4]. The authors from two studies could reveal the proportion of synchronous tumor from metachronous tumor among both endometriod histology in endometrium and ovary from cancer registry of endometrial cancer and ovarian cancer, respectively.…”

“…The proportion of genetic background and germline mutation in Korean women with gynecologic cancer is comparable to those of western ethnics [1,2]. Two interesting articles dealing synchronous cancers of endometrium and ovary appeared in the December issue [3,4]. The 5-year overall survival of women with synchronous cancers of endometrium and ovary was 78% from Singapore [3].…”