Ovarian endometrioid carcinoma and clear cell carcinoma: A 21-year retrospective study

Huiping Liu,Ling Zhou,Xue Ye,Ruiqiong Ma,Heng Cui,Hongyan Cheng,Liqing Yao,Honglan Zhu,Lin Dai,Xiaohong Chang,Shang Wang

doi:10.1186/s13048-021-00804-1

Huiping Liu, Ling Zhou + Show 9 more

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https://doi.org/10.1186/s13048-021-00804-1

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Abstract

ObjectiveThis study aimed to identify the clinical characteristics of Chinese patients with ovarian endometrioid carcinoma (EC) and clear cell carcinoma (CCC) and to assess the impact of concurrent endometriosis on this group.MethodsThe present study reviewed the medical records of patients who received initial treatment and a postoperative pathological diagnosis of EC or CCC at our center in China between 1998 and 2018.ResultsOf 211 patients, 73 had pure EC, and 91 had pure CCC, and the remaining 47 had mixed cancer. The proportion of EC and CCC remained stable over past 21 years. The proportion of EC declined with aging and the age of EC onset to incline to the young. And the age of CCC onset had two peaks, namely, 36 and 77 years. After review by the pathologist, the number of endometriosis cases found in the pathological section of the analysis increased to 114, accounting for 54% of patients. As the stage progressed, the appearance of endometriosis became increasingly scarce in pathological sections(p = 0.001).Compared with CCC, EC had a higher frequency of concurrent endometrial cancer (independent endometrial lesions) and estrogen and progesterone receptor expression(p = 0.000). And more patients were in premenopausal state in EC group(p = 0.040).In the pure group, multivariate analysis showed that correlation existed between relevance to endometriosis and worse outcomes(p = 0.041). In patients with mixed cancer, mixed endometrioid histology was associated with better survival than other subtypes, even with stage III or poorly differentiated tumors(p = 0.001).ConclusionsCCC and EC which are common in ovarian cancer patients who have associated with endometriosis have distinct clinicopathological characteristics. Attention should be paid to ovarian cancer patients with a history of endometriosis and those with concurrent endometriosis in pathological sections.

Highlights

Ovarian cancer is the second most common gynecologic malignancy, with over 90% of cancers arising from epithelial cell s[1, 2]
The proportion of serous ovarian cancer gradually increased with increasing age while the proportion of endometrioid carcinoma (EC) declined with aging (Fig. 2b)
After review by the pathologist, the number of endometriosis cases found in the pathological section of the analysis increased to 114, accounting for 54% of patients

Summary

Introduction

Ovarian cancer is the second most common gynecologic malignancy, with over 90% of cancers arising from epithelial cell s[1, 2]. The most common histology of epithelial ovarian carcinoma (EOC) is papillary serous carcinoma, accounting for 70% of all EOCs in North America, followed by the endometrioid and clear cell histological types, which account for 20–25% and 5–10% of EOCs, respectively, of EOC s[2,3,4,5]. Sampson defined endometriosis-associated ovarian cancer (EAOC) as endometriosis that was found in the surgical specimen but not in direct continuity with the tumor [11,12,13]. It is well known that tumors associated with endometriosis are confined to specific subcategories of disease, namely, endometrioid carcinoma (EC) and clear cell carcinoma (CCC)

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