Endometriosis-Associated Ovarian Cancer Population Characteristics and Prognosis
Endometriosis-Associated Ovarian Cancer Population Characteristics and Prognosis
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DOI：
10.1097/igc.0000000000001317
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发表时间：
2018-09-01
影响因子：
4.8
通讯作者：
Derchain, Sophie
中科院分区：
文献类型：
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作者：
Barreta, Amilcar;Sarian, Luis;Derchain, Sophie
目的：本研究的目的是分析和比较卵巢透明细胞癌（CCOC）和卵巢上皮样癌（EOC）伴或不伴子宫内膜异位症的临床病理特征和预后。这是一项重组的队列研究，来自一个单一的-机构巴西癌症中心在审查委员会编号68150617.7.0000.5404下批准，1995年至2016年期间诊断了50例CCOC和EOC患者，追踪到2017年。结果：CCOC组23例（46%），EOC组27例（54%），其中80%的患者经病理证实为子宫内膜异位症，42%的患者为初产妇，42%的患者为绝经前妇女。而癌抗原125在国际妇产科联合会I-II期疾病中均升高（平均值，614.7 Ui/mL;范围，3-6030 Ui/mL）或国际妇产科联合会疾病分期（平均值，2361.2 Ui/mL;范围，8-12771 Ui/mL）。EOC组比CCOC组年轻7岁。当与子宫内膜异位症相关时，CCOCs更可能在早期诊断。子宫内膜样卵巢癌与初发的CCOC和晚期的EOC预后相似。单因素分析显示，与子宫内膜异位症无关的CCOC的总生存率（OS）较差。然而，多变量分析显示，只有异常升高的癌抗原125水平和诊断时的晚期与无进展生存率降低显著相关。肿瘤分期仍然是唯一的预后因素OS。结论：并存子宫内膜异位症的存在并没有改变EOC的预后，但与CCOC患者更好的OS。初发CCOC、EOC和晚期EOC患者预后良好，但晚期CCOC复发快，OS短。
Objective: The aim of this study was to analyze and compare the clinicopathologic features and prognosis of clear cell ovarian carcinoma (CCOC) and endometrioid ovarian carcinoma (EOC) associated or not with endometriosis.Methods: This was a reconstituted cohort study from a single-institution Brazilian cancer center approved under review board no. 68150617.7.0000.5404 with 50 patients with CCOC and EOC diagnosed between 1995 and 2016, followed up until 2017. Clinicopathologic characteristics and survival outcomes were analyzed.Result(s): There were 23 women (46%) with CCOC and 27 with EOC (54%); 80% of those women had histologic confirmation of endometriosis; 42% were nulliparous, and 42% were premenopausal; and cancer antigen 125 was elevated in both International Federation of Gynecology and Obstetrics stages I-II disease (mean, 614.7 Ui/mL; range, 3-6030 Ui/mL) or International Federation of Gynecology and Obstetrics stages disease (mean, 2361.2 Ui/mL; range, 8-12771 Ui/mL). Women with EOC were 7 years younger than those with CCOC. When associated with endometriosis, CCOCs were more likely diagnosed at earlier stages. Endometrioid ovarian carcinoma and CCOC at initial stage and EOC at advanced stage share similar good prognosis. Univariate analysis showed that CCOC not associated with endometriosis has worse overall survival (OS). However, multivariate analysis showed that only abnormally elevated levels of cancer antigen 125 and advanced stage at diagnosis were significantly associated with reduced progression-free survival. Tumor stage remains the only prognostic factor for OS.Conclusions: The presence of coexisting endometriosis did not change the prognosis of EOC but was associated with better OS in patients with CCOC. Patients with CCOC and EOC at initial stages and EOC at advanced stages have a good prognosis; however, CCOC at advanced stages had a sooner recurrence and shorter OS.