Predictive factors of ovarian carcinoma for women with ovarian endometrioma aged 45 years and older in China

Abstract

BackgroundTo explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis (OEM) aged 45 years and above in China.MethodsThis study reviewed the medical records of 1038 women in total who were aged 45 years and above, surgical-pathologically diagnosed with ovarian endometriosis, and were treated at Peking Union Medical College Hospital between December 1996 and December 2016. Histology evaluation was used to determine whether the ovarian endometriosis specimen was with (n = 30) or without (n = 1008) ovarian cancer.Results2.9% (30/1038) of women with the surgical-pathological diagnosis of ovarian endometriosis were found to have EAOC. Those patients with EAOC were prone to be in the postmenopausal status at the time of the diagnosis (OR 5.50, 95%CI 2.54–11.90, P < .001) and larger size of tumor (≥8 cm, OR 7.19, 95% CI 3.34–15.50, P < .001), and higher prevalence of coexisting with endometrial disorders (OR 4.11, 95%CI 1.73–9.73, P = .003). This study showed that patients of an older age when diagnosed with OEM, were at a higher risk of developing EAOC, respectively measuring of 1.7% (13/751) at 45–49 years, 5.6% (12/215) at 50–54 years, and 10.0%(5/50) at 55–59 years (P < 0.001).ConclusionsThis study showed that for women aged 45 years and above who were diagnosed with OEM, the independent risk factors of EAOC were menopausal status, tumor size of 8 cm or greater in diameter, and coexisting endometrial disorders. Therefore, intensive follow-ups or active interventions should be considered for them.

Significant risk factors for malignant transformation of ovarian endometrioma during dienogest treatment: a case report and retrospective study

“…Of the six factors, advanced age, nullipara and increased size and recurrence showed significant increases in the probability of MT. In contrast to a previous study in which the association between spontaneous pregnancy and the disease progression of endometriosis was unclear [25], these results were roughly consistent with those of past reports [26, 27]. In particular, 19 patients who had all three factors showed a probability of over 20% for the occurrence of ovarian carcinoma (21.1%, n = 4 of 19).…”

Sonographic features differentiating early-stage ovarian clear cell carcinoma from endometrioma with atypical features

“…However, with increasing age, endometriomas are more likely to present as multilocular cysts, cysts with solid components, and cysts with decreased ground-glass echogenicity [18]. In addition, most OCCCs (c, d) lesions wider than they are tall, (e, f) floating tumors, (g) solid components with papillary structure, and (h, i) solid components lack ascites at the time of diagnosis, and the pre-operative CA-125 serum values was not significantly different between endometriosis patients with or without EAOCs [10,16,19]. These factors influence diagnostic value of the IOTA method and confuse examiners who are making conclusions.…”

“…*Correspondence: bcsheu@ntu.edu.tw EAOC occurs in women of older ages and is characterized by the presence of solid components and larger tumor sizes [10,16,17]. Sonography remains the first choice for assessment of the risk of malignancy.…”

“…Surgery may be reserved for those with failed medical treatments or when a malignancy is suspected [5,7]. Endometriosis-associated ovarian cancers (EAOC) present in 0.14%-2.9% of patients with endometriomas [10][11][12][13][14]. Among EAOCs, the most common histology is ovarian clear cell carcinoma (OCCC) [15].…”

Endometriosis-associated Ovarian Clear Cell Carcinoma: A Special Entity?

“…Most patients with endometriosis-associated OCCC have a history of endometriosis. If patients with endometriosis have the following conditions, the possibility of malignancy should be highly considered: (1) early diagnosed or long-standing endometriosis, (2) larger size of pelvic mass (diameter ≥9 cm), (3) a rapid increase of mass in a short period, (4) short-term recurrences after treatment, and (5) postmenopausal status at the time of the diagnosis [128][129][130][131][132][133][134]. Through a long period follow-up, Varma found an average year for malignant transformation of endometriosis to ovarian cancer was more than 8 years [135].…”