PURPOSE: Patients with synchronous ovarian and endometrial cancers may represent cases of a single primary tumor with metastasis (SPM) or dual primary tumors (DP). The diagnosis given will influence the patient's treatment and prognosis. Currently, a diagnosis of SPM or DP is made using histologic criteria, which are frequently unable to make a definitive diagnosis. EXPERIMENTAL DESIGN: In this study, we used genetic profiling to make a genetic diagnosis of SPM or DP in 90 patients with synchronous ovarian/endometrial cancers. We compared genetic diagnoses in these patients with the original histologic diagnoses and evaluated the clinical outcome in this series of patients based on their diagnoses. RESULTS: Combining genetic and histologic approaches, we were able make a diagnosis in 88 of 90 cases, whereas histology alone was able to make a diagnosis in only 64 cases. Patients diagnosed with SPM had a significantly worse survival than patients with DP (P = 0.002). Patients in which both tumors were of endometrioid histology survived longer than patients of other histologic subtypes (P = 0.025), and patients diagnosed with SPM had a worse survival if the mode of spread was from ovary to endometrium rather than from endometrium to ovary (P = 0.019). CONCLUSIONS: Genetic analysis may represent a powerful tool for use in clinical practice for distinguishing between SPM and DP in patients with synchronous ovarian/endometrial cancer and predicting disease outcome. The data also suggest a hitherto uncharacterized level of heterogeneity in these cases, which, if accurately defined, could lead to improved treatment and survival.
PURPOSE:Patients with synchronous ovarian and endometrial cancers may represent cases of a single primary tumor with metastasis (SPM) or dual primary tumors (DP). The diagnosis given will influence the patient's treatment and prognosis. Currently, a diagnosis of SPM or DP is made using histologic criteria, which are frequently unable to make a definitive diagnosis. EXPERIMENTAL DESIGN: In this study, we used genetic profiling to make a genetic diagnosis of SPM or DP in 90 patients with synchronous ovarian/endometrial cancers. We compared genetic diagnoses in these patients with the original histologic diagnoses and evaluated the clinical outcome in this series of patients based on their diagnoses. RESULTS: Combining genetic and histologic approaches, we were able make a diagnosis in 88 of 90 cases, whereas histology alone was able to make a diagnosis in only 64 cases. Patients diagnosed with SPM had a significantly worse survival than patients with DP (P = 0.002). Patients in which both tumors were of endometrioid histology survived longer than patients of other histologic subtypes (P = 0.025), and patients diagnosed with SPM had a worse survival if the mode of spread was from ovary to endometrium rather than from endometrium to ovary (P = 0.019). CONCLUSIONS: Genetic analysis may represent a powerful tool for use in clinical practice for distinguishing between SPM and DP in patients with synchronous ovarian/endometrial cancer and predicting disease outcome. The data also suggest a hitherto uncharacterized level of heterogeneity in these cases, which, if accurately defined, could lead to improved treatment and survival.
Authors: Anne M Schultheis; Charlotte K Y Ng; Maria R De Filippo; Salvatore Piscuoglio; Gabriel S Macedo; Sonia Gatius; Belen Perez Mies; Robert A Soslow; Raymond S Lim; Agnes Viale; Kety H Huberman; Jose C Palacios; Jorge S Reis-Filho; Xavier Matias-Guiu; Britta Weigelt Journal: J Natl Cancer Inst Date: 2016-02-01 Impact factor: 13.506
Authors: Lea A Moukarzel; Arnaud Da Cruz Paula; Lorenzo Ferrando; Timothy Hoang; Ana Paula Martins Sebastiao; Fresia Pareja; Kay J Park; Achim A Jungbluth; Gabriel Capella; Marta Pineda; Jeffrey D Levin; Nadeem R Abu-Rustum; Lora H Ellenson; August Vidal Bel; Jorge S Reis-Filho; Xavier Matias-Guiu; Karen Cadoo; Zsofia K Stadler; Britta Weigelt Journal: Mod Pathol Date: 2020-12-16 Impact factor: 7.842