How to manage synchronous endometrial and ovarian cancer patients?

BMC Cancer. 2021 May 1;21(1):489. doi: 10.1186/s12885-021-08220-w.

Abstract

Backgrounds: We aimed to evaluate the prognosis in patients with synchronous endometrial and ovarian cancer (SEOC) by comparing the differences between double primary cancer (DPC) and metastatic cancer (MC).

Methods: The medical records of 47 patients diagnosed synchronously with endometrial and ovarian cancer between January 2006 and December 2018 were retrospectively reviewed. Twenty-eight and 19 patients were diagnosed with DPC and MC, respectively. Demographics, recurrence-free survival (RFS), and 5-year overall survival (OS) were compared. The clinical factors affecting survival were evaluated using univariate and multivariate analyses.

Results: The demographics were not different between both groups. Endometrioid histology and the International Federation of Gynecology and Obstetrics grade were higher in the MC group than in the DPC group (42.1% vs. 10.7%; P = 0.018, P = 0.002, respectively). The ratio of post-operative adjuvant therapy was not different in both groups. Recurrence occurred in five patients with DPC and seven with MC. The difference in RFS was not significantly different (P = 0.131) but the OS was different between both groups (P = 0.020). Histology and para-aortic lymph node metastasis were associated wtih RFS in univariate analysis, but no difference was found in multivariate analysis.

Conclusions: Although DPC patients had longer OS, multivariate analysis did not identify any influential factors. Focus should be placed on defining the appropriate adjuvant treatment for high-risk patients, which will improve prognosis, rather than on discriminating between DPC and MC.

Keywords: Endometrial neoplasms; Metastasis; Ovarian cancer; Prognosis; Synchronous cancer.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Disease-Free Survival
  • Endometrial Neoplasms* / mortality
  • Endometrial Neoplasms* / pathology
  • Endometrial Neoplasms* / therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local
  • Neoplasms, Multiple Primary* / mortality
  • Neoplasms, Multiple Primary* / pathology
  • Neoplasms, Multiple Primary* / therapy
  • Ovarian Neoplasms* / mortality
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / secondary
  • Ovarian Neoplasms* / therapy
  • Prognosis
  • Retrospective Studies
  • Young Adult