Clinicopathological and prognostic outcomes of endometriosis-associated ovarian cancer

Esra Keleş, Sahra Sultan Kara, Sadun Sucu
In: Ağrı Tıp Fakültesi Dergisi · 2025 · vol. 3(3) , pp. 102–106 · doi:10.61845/agrimedical.1674787 · W4415666315
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Endometriosis-associated ovarian cancer cases presented in younger patients at earlier FIGO stages with higher CA 19-9 levels, but showed no significant differences in recurrence rates or survival outcomes compared to non-endometriosis-associated cases.

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The paper examines clinicopathological features and prognostic outcomes of endometriosis-associated ovarian cancer, synthesizing information on how these cancers present and what survival or other outcome patterns are reported in relation to endometriosis involvement. It uses a study-design typical of clinical/clinicopathological outcome research, focusing on patient characteristics and prognostic endpoints rather than mechanistic experiments. A key limitation is that, as indicated by the framing and context of the topic, prognostic comparisons are potentially constrained by heterogeneity across studies and by limitations inherent in retrospective clinical datasets and varied classification of ovarian tumors. This paper is centrally about endometriosis—specifically, it focuses on ovarian cancer occurring in association with endometriosis and its clinicopathological and prognostic outcomes.

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Abstract

Aim: The aim of this study is to investigate the clinicopathological characteristics and prognostic value of endometriosis in patients with ovarian cancer. Materials and Methods: A retrospective analysis was performed on 273 patients with ovarian carcinoma between January 2013 and December 2023. Patients were stratified into endometriosis-associated ovarian carcinoma (EAOC) and non-endometriosis-associated ovarian carcinoma (non-EAOC). Clinicopathological variables, including age, menopausal status, tumor size and volume, FIGO stage, histological subtype, serum tumor markers, and survival outcomes, were evaluated. Results: EAOC patients were significantly younger than non-EAOC patients (respectively 51 ± 11.4 years, 59 ± 11.2 years; p = 0.002). EAOC cases were more frequently diagnosed at FIGO stage I than non-EAOC cases (p = 0.001), whereas FIGO stage (III) disease was more prevalent in the non-EAOC group (p = 0.007). No significant differences were observed in CA-125 levels between groups. CA 19-9 levels were elevated in the EAOC group (p = 0.012). Recurrence rates and survival outcomes did not differ significantly between the groups. Conclusion: EAOC cases were diagnosed at a younger age and presented at an earlier FIGO stage and had elevated CA 19-9 levels. However, survival outcomes did not significantly differ between EAOC and non-EAOC groups.
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References

- Sampson J. Endometrial carcinoma of the ovary arising in endometrial tissue in that organ. Arch Surg. 1925;10:1–72. - Giannella L, Marconi C, Di Giuseppe J, Delli Carpini G, Fichera M, Grelloni C, et al. Malignant Transformation of Postmenopausal Endometriosis: A Systematic Review of the Literature. Cancers. 2021;13(16):4026. - Rolla E. Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Research. 2019;8. - Scott RB. Malignant changes in endometriosis. Obstet Gynecol. 1953;2:283. - Wang S, Qiu L, Lang JH, Shen K, Yang JX, Huang HF, et al. Clinical analysis of ovarian epithelial carcinoma with coexisting pelvic endometriosis. Am J Obstet Gynecol. 2013;208(5):413.e1-5. - Kondi-Pafiti A, Papakonstantinou E, Lavazzo C, Grigoriadis C, Salakos N, Gregoriou O. Clinicopathological characteristics of ovarian carcinomas associated with endometriosis. Arch Gynecol Obstet. 2012;285:479–83. - Noli S, Cipriani S, Scarfone G, Villa A, Grossi E, Monti E, et al. Long term survival of ovarian endometriosis associated clear cell and endometrioid ovarian cancers. Int J Gynecol Cancer. 2013;23(2):244-8. - Orezzoli JP, Russell AH, Oliva E, Del Carmen MG, Eichhorn J, Fuller AF. Prognostic implication of endometriosis in clear cell carcinoma of the ovary. Gynecol Oncol. 2008;110:336–44. Details Primary Language English Subjects Gynecologic Oncology Surgery Journal Section Research Article Authors Esra Keles * 0000-0001-8099-8883 Türkiye Sahra Sultan Kara 0000-0001-5122-829X Türkiye Sadun Sucu 0000-0003-3758-0136 Türkiye Publication Date October 29, 2025 Submission Date April 12, 2025 Acceptance Date September 12, 2025 Published in Issue Year 2025 Volume: 3 Number: 3

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