The Association of Endosalpingiosis with Gynecologic Malignancy

Abstract

Study Objective Endosalpingiosis (ES) has been shown to potentially have a relationship with gynecologic malignancy based on case reports and case series. This study sought to determine the association of ES with gynecologic cancer and provide details regarding cancer type and time until diagnoses. Design A retrospective cohort analysis from 2000 through 2020 of all patients who underwent a gynecologic surgery with pathology consistent with ES at a nationwide, multi-site institution. Data was obtained by searching pathology reports for the search term “endosalpingiosis.” Setting Academic tertiary care centers including three distinct institutions. Patients or Participants Patients with pathology-proven ES. Interventions Gynecologic surgery. Measurements and Main Results A total of 505 patients met inclusion criteria. Demographic data showed a mean age of 52.9 years at the time of surgery (range 15.7 – 95.4), white race (91.7%), and married marital status (64.6%). Mean body mass index (BMI) was 29.8kg/m2 (range 15.3kg/m2 – 58.5kg/m2). Of patients with ES on pathology, 97 (19.2%) had concurrent endometriosis. Indications for surgery varied, with 145 (28.7%) having surgery for a pelvic mass, 149 (29.5%) for known or suspected cancer, and 80 (15.8%) for pelvic pain. There were 57 (11.3%) ES patients with a pre-existing diagnosis of malignancy and 218 (43.2%) with a post-operative diagnosis of malignancy. Of those with a post-operative diagnosis of malignancy, 204 (93.6%) were diagnosed concurrently during surgery for ES. The most common associated cancers were ovarian (n=96, 44.0%) and uterine (n=90, 41.3%). Mean time from ES diagnosis until malignancy diagnosis was 6.3 months. At the time of analysis, 415 patients (82.2%) were still living, with a total mean follow-up time of 75.6 months (range 0 – 249.9). Conclusion The presence of ES has an association with malignancy, specifically, uterine and ovarian cancers. Additional analysis comparing ES and endometriosis is warranted to determine if this association remains significant. Endosalpingiosis (ES) has been shown to potentially have a relationship with gynecologic malignancy based on case reports and case series. This study sought to determine the association of ES with gynecologic cancer and provide details regarding cancer type and time until diagnoses. A retrospective cohort analysis from 2000 through 2020 of all patients who underwent a gynecologic surgery with pathology consistent with ES at a nationwide, multi-site institution. Data was obtained by searching pathology reports for the search term “endosalpingiosis.” Academic tertiary care centers including three distinct institutions. Patients with pathology-proven ES. Gynecologic surgery. A total of 505 patients met inclusion criteria. Demographic data showed a mean age of 52.9 years at the time of surgery (range 15.7 – 95.4), white race (91.7%), and married marital status (64.6%). Mean body mass index (BMI) was 29.8kg/m2 (range 15.3kg/m2 – 58.5kg/m2). Of patients with ES on pathology, 97 (19.2%) had concurrent endometriosis. Indications for surgery varied, with 145 (28.7%) having surgery for a pelvic mass, 149 (29.5%) for known or suspected cancer, and 80 (15.8%) for pelvic pain. There were 57 (11.3%) ES patients with a pre-existing diagnosis of malignancy and 218 (43.2%) with a post-operative diagnosis of malignancy. Of those with a post-operative diagnosis of malignancy, 204 (93.6%) were diagnosed concurrently during surgery for ES. The most common associated cancers were ovarian (n=96, 44.0%) and uterine (n=90, 41.3%). Mean time from ES diagnosis until malignancy diagnosis was 6.3 months. At the time of analysis, 415 patients (82.2%) were still living, with a total mean follow-up time of 75.6 months (range 0 – 249.9). The presence of ES has an association with malignancy, specifically, uterine and ovarian cancers. Additional analysis comparing ES and endometriosis is warranted to determine if this association remains significant.