Clinical outcomes of patients with clear cell and endometrioid ovarian cancer arising from endometriosis

E Sun Paik, Tae‐Joong Kim, Chel Hun Choi, Byoung‐Gie Kim, Duk‐Soo Bae, Jeong‐Won Lee
Journal of gynecologic oncology · 2017 · vol. 29(2) , pp. e18 · doi:10.3802/jgo.2018.29.e18 · PMID:29400011 · PMC5823979 · W2771330658
article OA: gold CC0 ⤵ 19 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Clear cell and endometrioid ovarian cancers arising from endometriosis are diagnosed earlier but are not a significant prognostic factor for patient survival.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study of 224 patients treated at Samsung Medical Center (2001–2015) examined clinicopathologic features and survival outcomes in clear cell and endometrioid epithelial ovarian cancers classified as arising from endometriosis using Sampson and Scott criteria, compared with similar cancers not arising from endometriosis. After propensity score matching and in analyses of the full cohort, endometriosis-associated cancers presented at an earlier age and earlier stage, with lower CA-125 levels, higher rates of no gross residual disease after debulking, and higher rates of negative lymph node metastasis, and Kaplan-Meier analysis showed better progression-free and overall survival in the endometriosis-associated group. However, multivariate analysis did not find endometriosis association to be a significant independent prognostic factor, and after propensity score matching survival differences were not significant. This paper is centrally about endometriosis — it specifically compares outcomes of ovarian clear cell and endometrioid cancers that arise from endometriosis versus those that do not.

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Abstract

OBJECTIVE: The aim of this investigation is to compare outcomes of patients according to the presence of cancer arising from endometriosis in ovarian clear cell carcinoma (CCC) and endometrioid carcinoma (EC). METHODS: This study retrospectively investigated 224 CCC and EC patients treated in Samsung Medical Center from 2001 to 2015 to identify cancer arising from endometriosis according to Sampson and Scott criteria. Propensity score matching was performed to compare patients arising from endometriosis to patients without endometriosis (ratio 1:1) according to stage, age, lymph node metastasis (LNM), cancer antigen (CA)-125 level, and residual status after debulking surgery. RESULTS: Forty-five cases arising from endometriosis were compared with 179 cases without endometriosis. CCC and EC arising from endometriosis tended to present with early age (mean, 45.2 vs. 49.2 years; p=0.003), early-stage (stages I and II, 92.7% vs. 62.3%; p<0.001), lower CA-125 level (mean, 307.1 vs. 556.7; p=0.041), higher percentages of no gross residual disease after surgery (87.8% vs.56.8%; p=0.001), and higher percentages of negative LNM (82.9% vs. 59.0%; p=0.008) compared to cases without endometriosis. Kaplan-Meier curves for progression-free survival (PFS) and overall survival (OS) showed better outcomes for groups with cancer arising from endometriosis (p=0.014 for PFS; and p=0.010 for OS). However, the association with endometriosis was not significant in multivariate analysis. Also, after propensity score matching, survival differences between the 2 groups were not significant. CONCLUSION: CCC and EC arising from endometriosis are diagnosed at an earlier age and stage. However, cancer arising from endometriosis was not a significant prognostic factor.

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Condition tags

endometriosis

MeSH descriptors

Carcinoma, Endometrioid Carcinoma, Endometrioid Endometriosis Ovarian Neoplasms Adenocarcinoma, Clear Cell Adult CA-125 Antigen CA-125 Antigen Carcinoma, Endometrioid Carcinoma, Endometrioid Endometriosis Endometriosis Endometriosis Female Humans Lymphatic Metastasis Middle Aged Neoplasm Recurrence, Local Neoplasm Recurrence, Local Neoplasm Staging

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References (27)

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