Clinicopathological characteristics of patients with synchronous primary endometrial and ovarian cancers: A review of 43 cases

Abstract

Abstract. Synchronous primary endometrial and ovarian cancers are uncommon. The purpose of this study was to evaluate the clinicopathological characteristics, treatment and prognosis of synchronous primary endometrial and ovarian cancers. The clinicopathological characteristics of 43 patients with synchronous primary endometrial and ovarian cancers in the Obstetrics and Gynecology Hospital of Fudan University between 1999 and 2009 were retrospectively reviewed. Our results revealed that the median age at the time of diagnosis was 51 years (range, 29-71). The common presenting symptoms were abnormal uterine bleeding (AUB, 65.12%), abdominal mass (25.58%), abdominal pain and abdominal fullness (39.53%). An elevated CA125 level was observed in the majority of patients (n=20, 76.9%). Endometrioid type accounted for 60.47% of uterine carcinomas and different pathological types, including serous adenocarcinoma, clear cell carcinoma, adenosquamous and acanthoadenocarcinoma, were also identified in synchronous primary endometrial and ovarian cancers. All patients underwent surgical intervention (hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy or debulking surgery). The 5-year survival rate was 86.05% and nine patients had recurrence (20.93%). The early stage group (FIGO stages I and II) had more favorable prognosis than the advanced stage group (FIGO stages III and IV; P<0.05). In conclusion, synchronous primary endometrial and ovarian cancers are different from either primary endometrial carcinoma or ovarian cancer and are usually identified at early stages with a good prognosis.

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

“…They reported 7 cases of ovarian mucinous carcinomas with endometrioid endometrial carcinomas in their study .Sylwia et al reported 10 cases of which 1 was ovarian mucinous carcinoma with endometrioid endometrial carcinoma [9] . Age of presentation in our case was 51 years which is correlating with previous studies [7].…”

“…Previous reports do suggest that majority of synchronous tumours present at stage I [4,7] . The treatment of synchronous endometrial and ovarian cancer depends on the pathological characteristics of each tumour [4,11] .…”

“…Though obesity is a known risk factor for endometrial carcinoma, there is no specific data to support the association of obesity with synchronicity. Majority of patients with synchronous tumours show elevated CA125 levels .Yuantaoliu et al reported a mean CA125 value of 161.7IU/ml in their study [7] . Endometriosis of ovaries is seen in majority of cases with synchronous tumours [3] .…”

“…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. Catharina et al reported 53 cases of synchronous endometrial and ovarian tumours of which 75% were endometrioid carcinomas 8 .…”

“…Presenting symptom of synchronous tumours is that of individual primary tumours [7] . In our case it was post menopausalbleeding .Soliman PT et al reported that 30 to 40% of patients with synchronous tumours were obese (BMI> 30kg/m 2 ) [10] .…”