Giovanna Scarfone1, Alice Bergamini2, Stefania Noli1, Antonella Villa1, Sonia Cipriani3, Gianluca Taccagni4, Paola Vigano'5, Massimo Candiani2, Fabio Parazzini3, Giorgia Mangili6. 1. Department of Obstetrics, Gynecology and Neonatology, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy. 2. Università Vita-Salute, San Raffale Scientific Institute, Milano, Italy. 3. Mario Negri Pharmacological Research Institute, Milan, Italy. 4. Department of Surgical Pathology, San Raffaele Scientific Institute, Milano, Italy. 5. Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milano, Italy. 6. Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milano, Italy. Electronic address: mangili.giorgia@hsr.it.
Abstract
OBJECTIVE: Endometrioid and clear cell ovarian tumors have been referred to as "endometriosis associated ovarian cancers". However, very few studies have compared clinical and prognostic features of endometriosis-associated cancers or cancers not associated with endometriosis according to specific histotypes. We have investigated clinical and histological features of the largest published series of clear cell ovarian cancers arising in endometriosis using a retrospective database. METHODS: Seventy three patients with a primary diagnosis of either pure clear cell ovarian cancer and mixed endometrioid-clear cell ovarian cancer have been divided into two groups according to the detection of cancer strictly arising from ovarian endometriosis or not (n=27 and n=46, respectively). Clinical and pathological data have been compared. RESULTS: Patients with clear cell carcinomas arising from endometriosis tend to be significantly younger (51.4±10.0 and 58.4±11.2years, p=0.02). FIGO stage, laterality, prevalence of pure versus mixed histology, and presence of synchronous endometrial carcinoma were not significantly different between the two groups. Unilateral ovarian involvement was more frequent in cases arising in endometriosis (85% vs 63%, p=0.04). Ascites was not found in any of the endometriosis-associated cancer cases vs 19.5% in patients without endometriosis. The presence of endometriosis did not affect 5-year overall survival rates. CONCLUSIONS: Endometriosis per se does not appear to be associated with a lower stage tumor or to predict prognosis in ovarian clear cell cancers. Unilateral involvement and reduced presence of ascites may be linked to the cystic nature of endometriosis which frequently presents as monolateral and in which associated tumors are more likely to be longer confined to the ovary before spreading.
OBJECTIVE: Endometrioid and clear cell ovarian tumors have been referred to as "endometriosis associated ovarian cancers". However, very few studies have compared clinical and prognostic features of endometriosis-associated cancers or cancers not associated with endometriosis according to specific histotypes. We have investigated clinical and histological features of the largest published series of clear cell ovarian cancers arising in endometriosis using a retrospective database. METHODS: Seventy three patients with a primary diagnosis of either pure clear cell ovarian cancer and mixed endometrioid-clear cell ovarian cancer have been divided into two groups according to the detection of cancer strictly arising from ovarian endometriosis or not (n=27 and n=46, respectively). Clinical and pathological data have been compared. RESULTS:Patients with clear cell carcinomas arising from endometriosis tend to be significantly younger (51.4±10.0 and 58.4±11.2years, p=0.02). FIGO stage, laterality, prevalence of pure versus mixed histology, and presence of synchronous endometrial carcinoma were not significantly different between the two groups. Unilateral ovarian involvement was more frequent in cases arising in endometriosis (85% vs 63%, p=0.04). Ascites was not found in any of the endometriosis-associated cancer cases vs 19.5% in patients without endometriosis. The presence of endometriosis did not affect 5-year overall survival rates. CONCLUSIONS:Endometriosis per se does not appear to be associated with a lower stage tumor or to predict prognosis in ovarian clear cell cancers. Unilateral involvement and reduced presence of ascites may be linked to the cystic nature of endometriosis which frequently presents as monolateral and in which associated tumors are more likely to be longer confined to the ovary before spreading.
Authors: Alexis D Greene; Stephanie A Lang; Jessica A Kendziorski; Julie M Sroga-Rios; Thomas J Herzog; Katherine A Burns Journal: Reproduction Date: 2016-05-10 Impact factor: 3.906
Authors: Helen E Dinkelspiel; Cathleen Matrai; Sara Pauk; Alain Pierre-Louis; Ya-Lin Chiu; Divya Gupta; Thomas Caputo; Lora Hedrick Ellenson; Kevin Holcomb Journal: Cancer Invest Date: 2016-03-17 Impact factor: 2.176