Endometriosis-associated ovarian cancer is not a distinct clinical entity among young patients: A 12-year cohort study

Eur J Surg Oncol. 2020 May;46(5):876-882. doi: 10.1016/j.ejso.2019.11.517. Epub 2019 Nov 30.

Abstract

Objectives: To investigate the clinicopathological features and prognostic value of endometriosis in young patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC).

Methods: The medical files and clinical follow-up data of patients aged 40 years or younger with OEC or OCCC between January 2006 and December 2017 who had undergone complete surgical staging followed by systemic chemotherapy were retrospectively reviewed.

Results: A total of 94 women were included in this study. Univariate analysis revealed that the progression-free survival (PFS) and overall survival (OS) rates of patients with endometriosis-associated ovarian carcinoma (EAOC) did not improve compared with those of patients without EAOC (5-year PFS: 80.0% vs. 75.9% and 5-year OS: 85.0% vs. 86.0%, respectively). Multivariate analyses confirmed that FIGO stage (II-IV), cytology-positive ascites or peritoneal washes and residual disease > 1 cm were independent predictors of PFS and that residual disease > 1 cm was the only predictor of OS.

Conclusions: Endometriosis is not independently associated with the prognosis of OEC and OCCC among young patients. The intrinsic relationship between endometriosis and ovarian cancer warrants further investigation.

Keywords: Endometriosis; Fertility preservation; Ovarian cancer; Young.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Clear Cell / complications
  • Adenocarcinoma, Clear Cell / metabolism
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / therapy*
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • CA-125 Antigen / metabolism
  • Carboplatin / administration & dosage
  • Carcinoma, Endometrioid / complications
  • Carcinoma, Endometrioid / metabolism
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / therapy*
  • Carcinoma, Ovarian Epithelial / complications
  • Carcinoma, Ovarian Epithelial / therapy*
  • Cisplatin / administration & dosage
  • Cohort Studies
  • Cytoreduction Surgical Procedures*
  • Dysmenorrhea / complications
  • Endometriosis / complications*
  • Female
  • Humans
  • Infertility, Female / complications
  • Kaplan-Meier Estimate
  • Membrane Proteins / metabolism
  • Multivariate Analysis
  • Neoplasm Staging
  • Neoplasm, Residual
  • Ovarian Diseases / complications*
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy*
  • Pelvic Pain / complications
  • Prognosis
  • Progression-Free Survival
  • Proportional Hazards Models
  • Survival Rate
  • Young Adult

Substances

  • CA-125 Antigen
  • MUC16 protein, human
  • Membrane Proteins
  • Carboplatin
  • Cisplatin