Abstract
This retrospective observational study examined trends, characteristics, and survival of women with synchronous endometrial and ovarian cancer (SEOC) in the Surveillance, Epidemiology, and End Results Program between 1973 and 2013. Among 235,454 women with primary endometrial cancer, synchronous ovarian cancer was seen in 4,082 (1.7%) women with the proportion being decreased from 2.0% to 1.6% between 1983 and 2013 (P=0.049); and the proportion of concurrent endometrioid tumors in the two cancer sites has increased from 24.2% to 49.9% among SEOC women (P<0.001). When compared to endometrial cancer without synchronous ovarian cancer, endometrioid histology in the two cancer sites was associated with improved cause-specific survival while non-endometrioid histology in the ovarian cancer was associated with decreased cause-specific survival (adjusted-P<0.01). Among 110,063 women with primary epithelial ovarian cancer, synchronous endometrial cancer was seen in 3,940 (3.6%) women with the proportion being increased from 2.2% to 4.4% between 1973 and 2013 (P<0.001); and the proportion of concurrent endometrioid tumors in the two cancer sites had increased from 24.3% to 50.2% among SEOC women (P<0.001). When compared to primary epithelial ovarian cancer without synchronous endometrial cancer, SEOC was associated with better cause-specific survival if ovarian cancer is endometrioid type or if endometrial cancer is endometrioid type (adjusted-P<0.001). Across the two cohorts, the proportion of SEOC reached to the peak in the late-40 years of age and then decreased significantly (P<0.001). In conclusion, our study suggests that synchronous ovarian cancer has decreased among endometrial cancer whereas synchronous endometrial cancer has increased among epithelial ovarian cancer.
Highlights
Synchronous endometrial and ovarian cancer (SEOC) is defined as the simultaneous presence of these two cancers at the time of diagnosis as opposed to metachronous cancer where these two cancers are diagnosed at different chronologic time points
When compared to endometrial cancer without synchronous ovarian cancer, endometrioid histology in the two cancer sites was associated with improved cause-specific survival while non-endometrioid histology in the ovarian cancer was associated with decreased cause-specific survival
Among 110,063 women with primary epithelial ovarian cancer, synchronous endometrial cancer was seen in 3,940 (3.6%) women with the proportion being increased from 2.2% to 4.4% between 1973 and 2013 (P
Summary
Synchronous endometrial and ovarian cancer (SEOC) is defined as the simultaneous presence of these two cancers at the time of diagnosis as opposed to metachronous cancer where these two cancers are diagnosed at different chronologic time points. SEOC is not a rare clinical entity; it has been reported in 3-10%. The substantial range of incidences for synchronous endometrial cancer in ovarian cancer may be due to the small sample sizes in the majority of prior analyses. Population-based statistics are missing regarding the incidence of synchronous ovarian cancer in endometrial cancer. The diagnosis of SEOC is generally made by histopathologic evaluation. Women with SEOC, those who have concordant endometrioid tumors in the two cancer sites, have been thought to have a favorable prognosis [1, 7]. Because prior studies evaluating prognosis have lacked a control group of endometrial cancer without synchronous ovarian cancer, the histologic pattern-specific survival of women with synchronous tumors relative to those without synchronous tumors will be useful to understand the clinical characteristics of this disease entity
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