Trends and outcomes of women with synchronous endometrial and ovarian cancer

Abstract

This retrospective observational study examined trends, characteristics, and survival of women with synchronous endometrial and ovarian cancer (SEOC) in the Surveillance, Epidemiology, and End Results Program between 1973 and 2013. Among 235,454 women with primary endometrial cancer, synchronous ovarian cancer was seen in 4,082 (1.7%) women with the proportion being decreased from 2.0% to 1.6% between 1983 and 2013 (P=0.049); and the proportion of concurrent endometrioid tumors in the two cancer sites has increased from 24.2% to 49.9% among SEOC women (P<0.001). When compared to endometrial cancer without synchronous ovarian cancer, endometrioid histology in the two cancer sites was associated with improved cause-specific survival while non-endometrioid histology in the ovarian cancer was associated with decreased cause-specific survival (adjusted-P<0.01). Among 110,063 women with primary epithelial ovarian cancer, synchronous endometrial cancer was seen in 3,940 (3.6%) women with the proportion being increased from 2.2% to 4.4% between 1973 and 2013 (P<0.001); and the proportion of concurrent endometrioid tumors in the two cancer sites had increased from 24.3% to 50.2% among SEOC women (P<0.001). When compared to primary epithelial ovarian cancer without synchronous endometrial cancer, SEOC was associated with better cause-specific survival if ovarian cancer is endometrioid type or if endometrial cancer is endometrioid type (adjusted-P<0.001). Across the two cohorts, the proportion of SEOC reached to the peak in the late-40 years of age and then decreased significantly (P<0.001). In conclusion, our study suggests that synchronous ovarian cancer has decreased among endometrial cancer whereas synchronous endometrial cancer has increased among epithelial ovarian cancer.

Fertility Preserving Surgery in A Woman with Synchronous Endometrial and Ovarian Cancer Followed by Successful Pregnancy Outcome: Case Report and Review of Literature

“…Most common histological combination was endometrioid cancer in both ovary and uterus (45.6%) followed by endometrioid cancer in uterus and non-endometrioid cancer in ovary (33%) and non-endometrioid cancer in both ovary and uterus (16.1%). Women with synchronous endometrioid cancer in both ovary and uterus were younger and had better 10 year survival rate (88.7%) compared to women with endometrioid carcinoma of uterus and non-endometrioid cancer of ovary (74.2%), non endometrioid cancer in both ovary and uterus (62.9%) and women with only endometrial carcinoma (80.7%) [5]. In another study [6], 3.3% of women with endometrial cancer and 2.7% of women with cancer of ovary had evidence of synchronous cancer of ovary or uterus respectively.…”

“…In one landmark study [5] (n=235,454 women with endometrial carcinoma), synchronous ovarian cancer was found in 1.7% of women with endometrial carcinoma, the incidence being highest (3.1-5%) in women between 29-47 years of age. The women with synchronous endometrial carcinoma and ovarian cancer were more often young black women with grade 1-2 tumors of endometrioid or serous histology type and stage I-II disease [5]. Most common histological combination was endometrioid cancer in both ovary and uterus (45.6%) followed by endometrioid cancer in uterus and non-endometrioid cancer in ovary (33%) and non-endometrioid cancer in both ovary and uterus (16.1%).…”

Synchronous Endometrial Malignant Mixed Mullerian Tumor and Ovarian High-Grade Serous Carcinoma: A Case Report and Review of Literature

“…SEOC is the simultaneous occurrence of both endometrial and ovarian cancers at the time of diagnosis. 6 Although a rare instance, SEOC is the most frequent of the synchronous female genital tract cancers, 2,7,12 which accounts for 0.7 to 1.8% of all gynecologic malignancies. 2 SEOCs occur in younger women than those with either of primary ovarian or primary endometrial malignancies.…”

“…2 SEOCs occur in younger women than those with either of primary ovarian or primary endometrial malignancies. 5,6 A population-based retrospective analysis of SEOCs by Matsuo et al showed that among the endometrial cancer cohorts, synchronous primary endometrioid endometrial and ovarian tumors accounted for majority of the cases; while synchronous primary nonendometrioid ovarian and endometrial tumors accounted for only 16% of the cases, 21.8% accounted for the high-grade (grades 2 and 3) tumors. 6 In their study, grade 3 synchronous primary nonendometrioid ovarian and endometrial carcinomas to which group the index case belongs, accounted for only 5% of the SEOCs.…”

“…4,5 Matsuo et al in a retrospective study reported a changing trend in the pattern of SEOCs: a decreasing synchronous ovarian cancer among endometrial cancers and increasing synchronous endometrial cancer among ovarian cancer, and the peak age of incidence being late 40s. 6 Although SEOC is well reported in literature, none has reported synchronous endometrial malignant mixed Mullerian tumor (MMMT) and ovarian high-grade serous carcinoma. However, there were reported cases of synchronous ovarian carcinoma in cases of MMMT of one ovary, broad ligament and mesentry [7][8][9][10] ; and synchronous primary ovarian and uterine MMMT.…”