Simultaneously Detected Endometrial and Ovarian Carcinomas— A Prospective Clinicopathologic Study of 74 Cases: A Gynecologic Oncology Group Study

doi:10.1006/gyno.2001.6400

Gynecologic Oncology

Volume 83, Issue 2, November 2001, Pages 355-362

https://doi.org/10.1006/gyno.2001.6400 Get rights and content

Abstract

Objectives. The coexistence of carcinomas of the endometrium and ovary occurs in about 10% of women with ovarian carcinoma. It is often unclear whether this represents synchronous primary tumors or metastasis from endometrium to ovary, or from ovary to endometrium; consequently, staging, therapy, and expected outcome are uncertain. The Gynecologic Oncology Group sought to study patients with simultaneously detected adenocarcinomas in the endometrium and ovary with disease grossly confined to the pelvis to explore the possible correlation among discrete tumor subsets, natural history, and survival.

Methods. Between 1985 and 1991, 85 patients were prospectively enrolled, of whom 74 were eligible. All were initially treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and staging laparotomy, with radiation and chemotherapy left to the discretion of the treating physician and patient. Fifteen pathologic variables were examined to identify differences in tumor behavior.

Results. Of the 74 patients, 23 (31%) had microscopic spread of tumor in the pelvis or abdomen. Sixty-four (86%) patients had endometrioid carcinomas in both the endometrium and the ovary, and endometriosis was found in the ovary of 23 (31%) patients. There was concordance between the histologic grade of the tumor in the ovary and the uterus in 51 (69%) patients. The estimated probability of recurrence 5 years following staging surgery is 15.1% (95% confidence interval (CI): 8.7–25.2%). The presence of metastasis discriminated two groups of patients that experienced different probabilities of recurrence within 5 years: 10.0% (95% CI: 4.32–21.3%) for those with tumors confined to the uterus and ovary and 27.1% (95% CI: 13.0–48.5%) for those with metastasis (hazard ratio = 4.6, P = 0.006). The histologic grades of ovarian and uterine tumors also distinguished groups of patients with different probabilities of recurrence at 5 years: 8.0% (95% CI: 2.8–21.3%) for those patients with no more than grade 1 disease at either site and 22.4% (95% CI: 11.8–38.4%) for those with a higher grade in either the ovary or the endometrium (hazard ratio = 3.1, P = 0.047). The estimated overall probability of surviving 5 years is 85.9% and that of surviving 10 years is 80.3%.

Conclusion. The prognosis for women with simultaneously detected carcinomas in the uterus and ovary with gross disease confined to the pelvis is surprisingly good, particularly for those with disease microscopically limited to the uterus and ovary or of low histologic grade.

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^☆: Please address reprint requests to Gynecologic Oncology Group, Administrative Office, 1234 Market Street, Philadelphia, PA 19107.

^☆☆: The following are participating institutions and the National Cancer Institute grants supporting this study: Oregon Health Sciences University*, Duke University Medical Center (CA 12534), Abington Memorial Hospital, University of Rochester Medical Center (CA 12482), Walter Reed Army Medical Center (CA 23501), University of Southern California at Los Angeles (CA 37535), Colorado Gynecologic Oncology Group P.C. (CA 15975), University of California at Los Angeles (CA 13630), Milton S. Hershey Medical Center (CA 16386), Georgetown University Hospital (CA 16938), University of Cincinnati*, University of Iowa Hospitals and Clinics (CA 19502), Indiana University Medical Center (CA 21720), Bowman Gray (CA 21946), University of California Medical Center at Irvine (23765), Tufts–New England Medical Center (CA 37569), Rush–Presbyterian–St. Luke's Medical Center, Eastern Virginia Medical School (CA 40296), State University of New York at Stony Brook*, Eastern Pennsylvania Gyn/Onc Center P.C.*, Washington University School of Medicine*, Cooper Hospital/University Medical Center, Columbus Cancer Council, and University of Massachusetts Medical Center. Institutions indicated by an asterisk are unfunded.

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Regular ArticleSimultaneously Detected Endometrial and Ovarian Carcinomas— A Prospective Clinicopathologic Study of 74 Cases: A Gynecologic Oncology Group Study☆,☆☆

Abstract

Gynecol Oncol

Gynecol Oncol

Int J Gynaecol Obstet

Gynecol Oncol

Hum Pathol

Gynecol Oncol

Patterns of other neoplasia in patients with endometrial carcinoma

Cancer

Adenoacanthomas of ovary and uterus occurring as coexistent or sequential primary neoplasms

Cancer

Primary and secondary ovarian adeno-acanthoma

Surg Gynecol Obstet

Regular Article
Simultaneously Detected Endometrial and Ovarian Carcinomas— A Prospective Clinicopathologic Study of 74 Cases: A Gynecologic Oncology Group Study☆,☆☆