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The prognostic significance of stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts: is it a myth?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to determine the clinicopathologic features and the prognostic significance of Stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts.

Materials and methods

Patients with either Stage I ovarian clear cell or endometrioid carcinoma were divided into three groups. *Group 1: Patients with cancers arising from endometriotic cysts *Group 2: Patients with ovarian and pelvic endometriosis *Group 3: Patients without endometriosis Patient characteristics (overall survival and disease-free survival) were compared between groups.

Results

Of the 78 patients who participated in this study, 39 were in group 1, 13 were in group 2, and 26 were in group 3. The mean age in groups 1, 2, and 3 were 46 years, 54 years, and 48 years, respectively (p = 0.39). Tumoral characteristics, including capsule rupture, positive cytology, grade, and the presence of synchronous endometrial cancer were similar in both groups. The 5-year overall survival rate in groups 1, 2, and 3 were 100, 90, and 93%, respectively (p = 0.4). Moreover, the recurrence rates did not differ significantly between groups. Furthermore, subgroup analysis of clear cell carcinoma and endometrioid adenocarcinoma separately showed no effect of endometriosis on disease-free survival (DFS) or overall survival (OS).

Conclusion

Clear cell or endometrioid ovarian carcinoma arising from ovarian and/or pelvic endometriosis shares the same clinicopathologic characteristics with their counterparts that do not arise from endometriosis and patients have similar overall and disease-free survival.

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References

  1. Redwine DB (1999) Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril 72(2):310–315

    Article  CAS  PubMed  Google Scholar 

  2. Kobayashi H, Sumimoto K, Moniwa N, Imai M, Takakura K, Kuromaki T et al (2007) Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan. Int J Gynecol Cancer 17(1):37–43

    Article  CAS  PubMed  Google Scholar 

  3. Ogawa S, Kaku T, Amada S, Kobayashi H, Hirakawa T, Ariyoshi K et al (2000) Ovarian endometriosis associated with ovarian carcinoma: a clinicopathological and immunohistochemical study. Gynecol Oncol 77(2):298–304

    Article  CAS  PubMed  Google Scholar 

  4. Melin A, Sparen P, Persson I, Bergqvist A (2006) Endometriosis and the risk of cancer with special emphasis on ovarian cancer. Hum Reprod 21(5):1237–1242

    Article  CAS  PubMed  Google Scholar 

  5. Kondi-Pafiti A, Papakonstantinou E, Iavazzo C, Grigoriadis C, Salakos N, Gregoriou O (2012) Clinicopathological characteristics of ovarian carcinomas associated with endometriosis. Arch Gynecol Obstet 285(2):479–483

    Article  CAS  PubMed  Google Scholar 

  6. Qiu L, Wang S, Lang JH, Shen K, Huang HF, Pan LY et al (2013) The occurrence of endometriosis with ovarian carcinomas is not purely coincidental. Eur J Obstet Gynecol Reprod Biol 170(1):225–228

    Article  PubMed  Google Scholar 

  7. Brinton LA, Lamb EJ, Moghissi KS, Scoccia B, Althuis MD, Mabie JE et al (2004) Ovarian cancer risk associated with varying causes of infertility. Fertil Steril 82(2):405–414

    Article  PubMed  Google Scholar 

  8. Pearce CL, Templeman C, Rossing MA, Lee A, Near AM, Webb PM et al (2012) Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies. Lancet Oncol 13(4):385–394

    Article  PubMed  PubMed Central  Google Scholar 

  9. Van Gorp T, Amant F, Neven P, Vergote I, Moerman P (2004) Endometriosis and the development of malignant tumours of the pelvis. A review of literature. Best Pract Res Clin Obstet Gynaecol 18(2):349–371

    Article  PubMed  Google Scholar 

  10. Orezzoli JP, Russell AH, Oliva E, Del Carmen MG, Eichhorn J, Fuller AF (2008) Prognostic implication of endometriosis in clear cell carcinoma of the ovary. Gynecol Oncol 110(3):336–344

    Article  CAS  PubMed  Google Scholar 

  11. Kumar S, Munkarah A, Arabi H, Bandyopadhyay S, Semaan A, Hayek K et al (2011) Prognostic analysis of ovarian cancer associated with endometriosis. Am J Obstet Gynecol 204(1):63 e1–63 e7

    Article  Google Scholar 

  12. Cuff J, Longacre TA (2012) Endometriosis does not confer improved prognosis in ovarian carcinoma of uniform cell type. Am J Surg Pathol 36(5):688–695

    Article  PubMed  Google Scholar 

  13. Wang S, Qiu L, Lang JH, Shen K, Huang HF, Pan LY et al (2013) Prognostic analysis of endometrioid epithelial ovarian cancer with or without endometriosis: a 12-year cohort study of Chinese patients. Am J Obstet Gynecol 209(3):241 e1–241 e9

    Article  Google Scholar 

  14. Kim HS, Kim TH, Chung HH, Song YS (2014) Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer 110(7):1878–1890

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Scarfone G, Bergamini A, Noli S, Villa A, Cipriani S, Taccagni G et al (2014) Characteristics of clear cell ovarian cancer arising from endometriosis: a two center cohort study. Gynecol Oncol 133(3):480–484

    Article  PubMed  Google Scholar 

  16. Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A (2011) Endometriosis as a prognostic factor for cancer survival. Int J Cancer 129(4):948–955

    Article  CAS  PubMed  Google Scholar 

  17. Ali-Fehmi R, Khalifeh I, Bandyopadhyay S, Lawrence WD, Silva E, Liao D et al (2006) Patterns of loss of heterozygosity at 10q23.3 and microsatellite instability in endometriosis, atypical endometriosis, and ovarian carcinoma arising in association with endometriosis. Int J Gynecol Pathol 25(3):223–229

    Article  PubMed  Google Scholar 

  18. Ayhan A, Mao TL, Seckin T, Wu CH, Guan B, Ogawa H et al (2012) Loss of ARID1A expression is an early molecular event in tumor progression from ovarian endometriotic cyst to clear cell and endometrioid carcinoma. Int J Gynecol Cancer 22(8):1310–1315

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mangili G, Bergamini A, Taccagni G, Gentile C, Panina P, Vigano P et al (2012) Unraveling the two entities of endometrioid ovarian cancer: a single center clinical experience. Gynecol Oncol 126(3):403–407

    Article  PubMed  Google Scholar 

  20. Munksgaard PS, Blaakaer J (2012) The association between endometriosis and ovarian cancer: a review of histological, genetic and molecular alterations. Gynecol Oncol 124(1):164–169

    Article  CAS  PubMed  Google Scholar 

  21. Ye S, Yang J, You Y et al (2014) Comparative study of ovarian clear cell carcinoma with and without endometriosis in People’s Republic of China. Fertil Steril 102:1656Y1662

    Article  Google Scholar 

  22. Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT et al (2018) Significance of ovarian endometriosis on the prognosis of ovarian clear cell carcinoma. Int J Gynecol Cancer 28(1):11–18

    Article  PubMed  Google Scholar 

  23. Modesitt SC, Tortolero-Luna G, Robinson JB, Gershenson DM, Wolf JK (2002) Ovarian and extraovarian endometriosis-associated cancer. Obstet Gynecol 100(4):788–795

    PubMed  Google Scholar 

  24. Schnack TH, Hogdall E, Thomsen LN, Hogdall C (2017) Demographic, clinical, and prognostic factors of ovarian clear cell adenocarcinomas according to endometriosis status. Int J Gynecol Cancer 27(9):1804–1812

    Article  PubMed  Google Scholar 

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Authors and Affiliations

Authors

Contributions

AA: project development, data collection and management, data analysis, manuscript writing, and editing. HA: project development, data collection, manuscript writing, and literature search. NH: data analysis and editing.

Corresponding author

Correspondence to Huseyin Akilli.

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Conflict of interest

The authors declare there are no conflicts of interest—financial or otherwise—related to the material presented herein.

Ethics approval

Ethical approval for the present study was not required, as it was retrospectively performed.

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Ayhan, A., Akilli, H. & Haberal, N. The prognostic significance of stage I ovarian clear cell and endometrioid carcinomas arising from endometriotic cysts: is it a myth?. Arch Gynecol Obstet 299, 217–222 (2019). https://doi.org/10.1007/s00404-018-4935-x

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  • DOI: https://doi.org/10.1007/s00404-018-4935-x

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