Clinical outcomes of patients with clear cell and endometrioid ovarian cancer arising from endometriosis.
- Author:
E Sun PAIK
1
;
Tae Joong KIM
;
Chel Hun CHOI
;
Byoung Gie KIM
;
Duk Soo BAE
;
Jeong Won LEE
Author Information
- Publication Type:Original Article
- Keywords: Ovarian Neoplasms; Endometriosis; Endometrioid Carcinoma; Clear Cell Carcinoma
- MeSH: Carcinoma, Endometrioid; Disease-Free Survival; Endometriosis*; Female; Humans; Lymph Nodes; Multivariate Analysis; Neoplasm Metastasis; Ovarian Neoplasms*; Propensity Score; Retrospective Studies
- From:Journal of Gynecologic Oncology 2018;29(2):e18-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The aim of this investigation is to compare outcomes of patients according to the presence of cancer arising from endometriosis in ovarian clear cell carcinoma (CCC) and endometrioid carcinoma (EC). METHODS: This study retrospectively investigated 224 CCC and EC patients treated in Samsung Medical Center from 2001 to 2015 to identify cancer arising from endometriosis according to Sampson and Scott criteria. Propensity score matching was performed to compare patients arising from endometriosis to patients without endometriosis (ratio 1:1) according to stage, age, lymph node metastasis (LNM), cancer antigen (CA)-125 level, and residual status after debulking surgery. RESULTS: Forty-five cases arising from endometriosis were compared with 179 cases without endometriosis. CCC and EC arising from endometriosis tended to present with early age (mean, 45.2 vs. 49.2 years; p=0.003), early-stage (stages I and II, 92.7% vs. 62.3%; p < 0.001), lower CA-125 level (mean, 307.1 vs. 556.7; p=0.041), higher percentages of no gross residual disease after surgery (87.8% vs.56.8%; p=0.001), and higher percentages of negative LNM (82.9% vs. 59.0%; p=0.008) compared to cases without endometriosis. Kaplan-Meier curves for progression-free survival (PFS) and overall survival (OS) showed better outcomes for groups with cancer arising from endometriosis (p=0.014 for PFS; and p=0.010 for OS). However, the association with endometriosis was not significant in multivariate analysis. Also, after propensity score matching, survival differences between the 2 groups were not significant. CONCLUSION: CCC and EC arising from endometriosis are diagnosed at an earlier age and stage. However, cancer arising from endometriosis was not a significant prognostic factor.
