Synchronous Primary Endometrial and Ovarian Cancers: A Multicenter Review of 63 Cases

Solmaz, Ulaş; Karataşlı, Volkan; Mat, Emre; Dereli, Levent; Hasdemir, Pınar Solmaz; Ekin, Atalay; Gezer, Cenk; Sayhan, Sevil; Şancı, Muzaffer; Güvenal, Tevfik

doi:10.5301/tj.5000378

Cited by 8 publications

(6 citation statements)

References 26 publications

(62 reference statements)

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“…We can say that these findings are similar to the literature [1,9,28,34,40,41]. The 5-year PFS of SOEC patients is around 65% [28][29][30]. The 5-year overall survival is between 73-86% [30,39].…”

Section: Discussionsupporting

confidence: 90%

“…In our study, among the patients operated for epithelial ovarian cancer, 36 patients were diagnosed with synchronous primary endometrial cancer and our rate was found to be 8.8% (36/409). When the literature is reviewed, the number of patients in most studies on this subject does not exceed 100 [7,[28][29][30]. At the same time, the correct recognition of this clinical condition is extremely important as it affects the adjuvant treatment and survival, because some SOEC patients are mistakenly diagnosed with stage 2A ovarian cancer or stage 3A endometrial cancer.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological risk factors and survival analysis of ovarian cancer with synchronous endometrial cancer diagnosed after surgery

Bakır¹,

Birge²,

Karadağ³

et al. 2021

EJGO

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In the present study, we tried to retrospectively evaluate the clinicopathological characteristics, prognosis and survival of patients with synchronous ovarian and endometrial cancer (SOEC). Material and methods: The data of patients with ovarian cancer who had been admitted to our hospital between February 2006 and March 2019 were retrospectively obtained from the hospital's electronic archive system collected after having obtained the ethics committee approval. Thirty-six patients with epithelial ovarian cancer and simultaneously diagnosed with primary endometrial cancer were included in the study. Patients with non-epithelial ovarian cancer, recurrent, metastatic and metachronous tumor, borderline ovarian tumor, uterine sarcoma and carcinosarcoma, and patients who had not attended regular controls were excluded from the study. Progression-free survival (PFS) and overall survival (OS) were compared using the Kaplan Meier survival analysis. The log rank test was used to test the effect of subgroups on survival. Results: The mean age of the SOEC patients included in the study was 52.05 ± 13.46 years. Of the patients, 8.3% had endometriosis and 16.7% had concurrent adenomyosis. Optimal surgery was seen to have been performed when evaluated with regard to post-operative residual tumor (R0, R1 and R2 61.1%, 33.3% and 5.6%, respectively). The histological grade was Grade 3 in most of the patients (44.4%). When the histology of SOEC patients was examined, endometrioid type was seen to be the most frequent in 18 patients (50%), followed by the serous type in 10 patients (27.8%). The least frequent was clear histology in 2 patients (5.6%). On the other hand, with regard to the endometrial cancer histology of SOEC patients, while the most common type was endometrioid type with 27 patients (75%), serous histological type was seen in 8 patients (22.2%). The fiveyear progression-free survival (PFS) was 43.6% for all patients, while the overall survival (OS) was 67.1%. The median PFS was 32 months, while the median OS was 89.6 months. In the subgroup analysis was performed as serous/serous histological type with SOEC patients with endometrioid/endometrioid, the median PFS was 53.8 months for the endometrioid/endometrioid type and 11.5 months for the serous/serous type, and it was statistically significant (p: 0.001). In terms of OS for both groups, it was 110.2 and 36.8 months, respectively, and it was statistically significant (p: 0.001). Conclusion: Endometrioid type endometrial cancer is more common than serous in synchronous ovarian and endometrial cancer patients and serous type has a worse prognosis than endometrioid.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Clinicopathological risk factors and survival analysis of ovarian cancer with synchronous endometrial cancer diagnosed after surgery

Bakır¹,

Birge²,

Karadağ³

et al. 2021

EJGO

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“…The current FIGO system assigns these patients as stage IIIA, which triggers adjuvant management by chemotherapy and radiotherapy in the European Society of Gynecologic Oncology and National Comprehensive Cancer Network treatment guidelines (1,2). This management approach may be overtreatment for a subset of such patients who have long been recognized to follow a favorable outcome that more closely aligns with patients whose disease is confined to the uterus (15)(16)(17)(18)(19)(20)(21)(22)(23)(24). This suggests that such patients are better served by being distinguished from the typical stage IIIA population and managed by less aggressive adjuvant treatment.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of Controversies and Unresolved Issues in the 2014 FIGO Staging System for Endometrial Cancer: Survey Results From Members of the International Society of Gynecological Pathologists and International Gynecologic Cancer Society

Kayraklioglu,

Katsakhyan,

Cohen

et al. 2023

International Journal of Gynecological Pathology

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Long-standing controversial and unresolved issues in the current “International Federation of Gynecology and Obstetrics” staging system for endometrial cancer are well-recognized by pathologists and clinicians alike and exist primarily as a result of limitations to the existing literature. To guide the design of future outcome-based studies specifically aimed at resolving such gaps, the International Society of Gynecologic Pathologists developed a survey of the current perceptions of pathologists (n = 172) and clinicians (n= 135) from the International Society of Gynecological Pathologists and from the International Gynecologic Cancer Society on areas for potential refinement of the current International Federation of Gynecology and Obstetrics staging system. The highest priority issues for pathologists and clinicians alike were the need to determine whether stage IIIA patients (ovarian/fallopian tube involvement) can be reliably separated into favorable versus unfavorable outcome groups to avoid over-treatment of the former group and to determine whether stage IIIC patients (lymph node metastases) can be separated into favorable versus unfavorable outcome groups based on the size of lymph node metastases. The majority of pathologists and clinicians viewed lymphovascular space invasion as an independent prognostic variable and favored incorporating lymphovascular space invasion into staging, though the level of support did not meet the threshold of 75% in support that we used to define a formal consensus. While pathologists did agree on the prognostic value of reporting the extent of lymphovascular space invasion, there was no consensus on the diagnostic criteria to distinguish focal versus substantial involvement. The majority of pathologists and clinicians viewed that a universally accepted protocol for sentinel lymph node ultra-staging is lacking. Both survey groups conveyed a slight preference for incorporating tumor histotype and molecular classification into staging but the support was short of the 75% threshold for formal consensus. Collectively, this survey permits the International Society of Gynecological Pathologists to develop a pathologist and clinician-driven long-term strategy for prioritizing and designing outcome-based studies specifically targeted to resolving controversial and unresolved issues in the International Federation of Gynecology and Obstetrics staging of endometrial cancer.

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“…The occurrence of synchronous primary endometrial and ovarian cancers in gynecological tumors is only 0.7%-1.8% [4]. They are clinically difficult to distinguish and often misdiagnosed for the metastasis of endometrial cancer to the ovary or ovarian cancer to the uterus.…”

Section: Discussionmentioning

confidence: 99%

Bilateral borderline ovarian cystadenoma with migration of intrauterine device to right ovary accompanied with endometrial carcinoma in situ: a case report

2020

Clinical and Experimental Obstetrics & Gynecology

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Synchronous bilateral borderline ovarian cystadenoma and endometrial cancer are rare in clinical practice which could easily cause some confusion in the diagnosis of primary tumor lesions. On the other hand, it is common for the intrauterine device (IUD) to migrate to the uterine muscle wall, pelvic cavity, abdominal cavity, intestinal canal and broad ligament etc. However, IUD migration to the ovary is rare. In this paper, a case of bilateral borderline ovarian cystadenoma with migration of IUD into the right ovary accompanied with endometrial carcinoma in situ is first reported.

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Synchronous Primary Endometrial and Ovarian Cancers: A Multicenter Review of 63 Cases

Abstract: Our study demonstrated that optimal cytoreduction, early-stage disease, and LVSI are the most significant factors affecting survival in women with SEOC.

Cited by 8 publications

References 26 publications

Clinicopathological risk factors and survival analysis of ovarian cancer with synchronous endometrial cancer diagnosed after surgery

Clinicopathological risk factors and survival analysis of ovarian cancer with synchronous endometrial cancer diagnosed after surgery

Perceptions of Controversies and Unresolved Issues in the 2014 FIGO Staging System for Endometrial Cancer: Survey Results From Members of the International Society of Gynecological Pathologists and International Gynecologic Cancer Society

Bilateral borderline ovarian cystadenoma with migration of intrauterine device to right ovary accompanied with endometrial carcinoma in situ: a case report

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