Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand

Tangjitgamol, Siriwan; Khunnarong, Jakkapan; Srijaipracharoen, Sunamchok

doi:10.3802/jgo.2015.26.4.293

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…Clinical data of other synchronous or metachronous cancer(s) in some patients were detailed in our previous work. 12 Among the pathologic features studied, early stages and absence of lymph node metastasis were significantly associated with higher rates of MMRd than the comparative groups. Although we found that EMC originated from lower uterine segment (LUS) and endometrioid cancer had higher rate of MMRd, the differences were not statistically significant.…”

Section: Resultsmentioning

confidence: 87%

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Prevalence and prognostic role of mismatch repair gene defect in endometrial cancer patients

2017

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The study was to evaluate the prevalence of mismatch repair gene defect among Thai patients with endometrial cancer and its association with clinico-pathological features and survivals. The formalin fixed paraffin-embedded blocks of EMC tissue from hysterectomy specimens of patients having surgery in our institution between 1 Jan 1995 and 31 December 2016 were assessed for the immunohistochemical expression of 4 mismatch repair proteins (MLH1, PMS, MSH2, MSH 6). Mismatch repair gene defect was determined by a negative expression of at least 1 protein. Among 385 EMC patients included in the study, mean age was 57.3 ± 10.8 years with 62.3% aged ⩽ 60 years. The most frequent mismatch repair gene defect was MSH6 (38.7%), followed by PMS2 (34.3%), MLH1 (33.2%), and MSH2 (16.4%). Overall, 55.1% showed negative expression of at least one protein. We found significantly higher mismatch repair gene defect in patients aged ⩽ 60 years, with early stage disease, and negative lymph node status than the other comparative groups: 59.2% vs 48.3% for age (p = 0.037), 58.2% vs 45.2% (p = 0.027) for stage, and 58.1% vs 44.6% (p = 0.048) for nodal status. The 5-year progression-free survival, overall survival, and endometrial cancer-specific survival of patients with mismatch repair gene defect was higher than those without gene defect. The differences were statistically significant for only progression-free survival and endometrial cancer-specific survival: 87.7% (95% confidence interval = 83.0%-92.4%) vs 81.5% (95% confidence interval = 75.4%-87.6%) (p = 0.049) for progression-free survival and 91.0% (95% confidence interval = 86.9%-95.1%) vs 85.5% (95% confidence interval = 80.0%-91.0%) (p = 0.044) for endometrial cancer-specific survival, respectively. In conclusion, more than half of Thai endometrial cancer patients had mismatch repair gene defect. The patients with mismatch repair gene defect had significantly younger age (⩽ 60 years) and better prognosis in terms of early stage, negative nodal status, and longer survivals.

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Section: Resultsmentioning

confidence: 87%

“…Clinical data of other synchronous or metachronous cancer(s) in some patients were detailed in our previous work. 12…”

Section: Resultsmentioning

confidence: 99%

Prevalence and prognostic role of mismatch repair gene defect in endometrial cancer patients

2017

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“…Moreover, the presence of synchronous endometrioid EC does not influence the prognosis of patients with stage I OC, even in the presence of deep myometrial invasion [11]. Other authors have found that the OS rate of EC patients who had other cancers was worse than that of patients without other cancers but that disease-specific survival was not significantly different [12]. Based on these data, an appropriate prognosis could be assured within this clinical context.…”

Section: Discussionmentioning

confidence: 97%

The prognosis of stage IA synchronous endometrial endometrioid and ovarian carcinomas

Zhan

et al. 2019

Arch Gynecol Obstet

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Introduction Little is known about the prevalence and prognosis of synchronous endometrial and ovarian carcinomas. This report explores the survival outcomes of synchronous stage IA endometrioid endometrial and stage IA ovarian carcinomas in a retrospective cohort study. Methods All cases of pathological confirmed synchronous stage IA endometrial endometrioid and ovarian carcinomas from June 1, 2010, to June 1, 2017, in a teaching hospital were reviewed. Patients were followed up to February 1, 2019. Survival outcomes were compared between patients with and without synchronous carcinomas. Results In total, 841 cases with confirmed FIGO stage IA endometrioid endometrial carcinomas were included in the study; 33 patients (3.9%) had synchronous stage IA ovarian carcinomas, including 27 (81.8%) and 6 (18.2%) cases of endometrioid and mixed endometrioid/clear cell subtypes, respectively. After a median follow-up time of 56.8 months, 829 patients (97.9%) had definitive survival outcomes. Synchronous ovarian carcinomas had no impact on disease-free, overall or cancer-specific overall survival in univariate and multivariate analyses. Conclusion In these patients with stage IA endometrioid endometrial carcinoma, the genuine incidence of synchronous stage IA ovarian carcinoma was very low, and synchronous carcinoma had no significant effects on survival outcomes.

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“…This was likely because the early detection of cervical cancer is increasing and the number of patients in the metachronous group was relatively higher than that in the synchronous group. The diagnostic interval between primary cancers of different origins of metachronous malignancy has been found to be 3–10 years [ 21 , 24 , 25 ]. The second cancer was diagnosed an average of 5 years after the diagnosis of primary gynecologic cancer in this study.…”

Section: Discussionmentioning

confidence: 99%

Multiple Primary Malignancies in Patients with Gynecologic Cancer

Yang

Lee

et al. 2021

JCM

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Objective: To investigate the prevalence and oncologic outcomes of patients with multiple primary malignant tumors (MPMT) with gynecologic cancer. Methods: This retrospective study included 1929 patients diagnosed with gynecologic cancer at a tertiary medical center between August 2005 and April 2021. The clinical data included cancer location, age at primary malignancy diagnosis, interval between primary and secondary cancer, stage of cancer, family history of cancer, genetic testing, dates of last follow-up, recurrence, and death. Results: The prevalence of MPMT with gynecologic cancer in patients was 8.6% and the mean diagnostic period between primary and secondary cancer was 60 months. Furthermore, 20 of the 165 patients with MPMT had multiple primary gynecologic cancers (MPGC), whereas 145 had gynecologic cancer coexisting with non-gynecologic cancer (GNC). Endometrial-ovarian cancer (60%) was the most common coexisting cancer in the MPGC group, whereas the most common non-gynecologic cancer in the GNC group was breast cancer (34.5%). There were 48 patients with synchronous cancer and 117 patients with metachronous cancer. The incidence of synchronous cancer was higher in the MPGC group than in the GNC group (p = 0.037). Significantly more patients had early-stage ovarian cancer in the MPGC group than in the GNC group (p = 0.031). The overall recurrence and mortality rates were 15.8% and 8.5%, respectively, in patients with MPMT. Conclusion: Synchronous cancer incidence was significantly higher in the MPGC than in the GNC group. Early-stage ovarian cancer was more highly diagnosed in patients with MPGC than in those with GNC. A systematic examination after primary cancer diagnosis could facilitate the early diagnosis of secondary primary malignancy, thereby improving patient prognosis.

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Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand

Cited by 10 publications

References 29 publications

Prevalence and prognostic role of mismatch repair gene defect in endometrial cancer patients

Prevalence and prognostic role of mismatch repair gene defect in endometrial cancer patients

The prognosis of stage IA synchronous endometrial endometrioid and ovarian carcinomas

Multiple Primary Malignancies in Patients with Gynecologic Cancer

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