J Gynecol Oncol.  2019 Jan;30(1):e7. 10.3802/jgo.2019.30.e7.

Prognostic factors of synchronous endometrial and ovarian endometrioid carcinoma

• Yoneoka Y
• Yoshida H
• Ishikawa M
• Shimizu H
• Uehara T
• Murakami T
• Kato T

• KMID: 2429576
• DOI: http://doi.org/10.3802/jgo.2019.30.e7

Abstract

OBJECTIVE
Gynecologists occasionally encounter synchronous endometrial and ovarian endometrioid carcinoma (SEO-EC) patients who show favorable prognosis than locally advanced or metastatic disease patients. This study aimed to elucidate prognostic factors of SEO-EC and identify patients who have a sufficiently low risk of recurrence without receiving adjuvant chemotherapy.
METHODS
We retrospectively reviewed 46 patients with pathologically confirmed SEO-EC who underwent surgery at the National Cancer Center Hospital between 1997 and 2016. Immunohistochemical evaluation of DNA mismatch repair (MMR) protein expression were performed for both endometrial and ovarian tumors. Patient outcomes were analyzed according to clinicopathologic factors.
RESULTS
From the multivariate analysis, cervical stromal invasion indicated a worse prognosis for progression-free survival (hazard ratio [HR]=6.85; 95% confidence interval [CI]=1.50-31.1) and overall survival (HR=6.95; 95% CI=1.15-41.8). Lymph node metastasis and peritoneal dissemination did not significantly affect survival. MMR deficiency was observed in 13 patients (28.3%), with both endometrial and ovarian tumors showing the same MMR expression status. MMR deficiency was not significantly associated with survival. Of 23 patients with lesions confined to only the uterine body and adnexa, only 2 had recurrence in the group receiving adjuvant therapy, while none of the 10 patients who did not receive adjuvant therapy had recurrence.
CONCLUSION
SEO-EC patients with tumors localized to the uterine body and adnexa lesions had a low risk for recurrence and may not require adjuvant therapy. SEO-EC may have prognostic factors different from those of endometrial and ovarian cancer.

Keyword

Synchronous Neoplasms; Prognostic Factors; Mismatch Repair Deficiency; Immunohistochemistry; Adjuvant Chemotherapy

MeSH Terms

Carcinoma, Endometrioid*
Chemotherapy, Adjuvant
Disease-Free Survival
DNA Mismatch Repair
Humans
Immunohistochemistry
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Neoplasms, Multiple Primary
Ovarian Neoplasms
Prognosis
Recurrence
Retrospective Studies