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

Objective: 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 ±$\pm$ 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 five-year 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.

Synchronous epithelial ovarian cancer; Endometrial cancer; Endometriosis; Survival

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