Improved clinical outcomes of patients with ovarian carcinoma arising in endometriosis

// Jiaqi Lu 1,* , Xiang Tao 3,* , Jiayi Zhou 2 , Yingying Lu 1 , Zehua Wang 2 , Haiou Liu 2 and Congjian Xu 1,2 1 Department of Gynaecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China 2 Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China 3 Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China * These authors have contributed equally to this work Correspondence to: Haiou Liu, email: // Congjian Xu, email: // Keywords : ovarian cancer, endometriosis, overall survival, progression-free survival, prognostic marker Received : May 30, 2016 Accepted : December 12, 2016 Published : December 15, 2016 Abstract Background: Despite enormous efforts to dissect the role of endometriosis in ovarian cancer development, the difference in prognosis between ovarian cancer patients with or without endometriosis remains elusive. The purpose of this study is to assess the association between endometriosis and the prognosis in patients with ovarian cancer. Results: Ovarian cancer arising in endometriosis tended to be presented as clear cell histology, early stage, less intraperitoneal metastasis and ascites, and lower CA125 level compared with those without endometriosis. Multivariate Cox regression analysis identified endometriosis as an independent prognostic factor for progression free survival ( P = 0.002) and overall survival ( P = 0.009) in all patients and especially for early stage. A nomogram integrating endometriosis, FIGO stage and CA125 was established to predict progression free survival and overall survival. Materials and methods: This study retrospectively enrolled 196 ovarian cancers arising or not in endometriosis judged by adjunctive use of CD10 immunohistochemistry in conjunction with H&E staining specimens. Clinicopathologic variables, progression-free survival (PFS) and overall survival (OS) were recorded. Kaplan-Meier analysis was performed to compare survival curves. Cox regression models were used to analyze the effect of endometriosis on PFS and OS. A prognostic nomogram was constructed based on the independent prognostic factors identified by multivariate analysis. Conclusions: Endometriosis is an independent predictor of prognosis in ovarian cancer patients.