Clinical Features And Prognosis Of Endometriosis Associated Ovarian Cancer

Objective:The clinical data of patients with ovarian clear cell carcinoma(OCCC)and ovarian endometrioid carcinoma(EAC)in Shanxi cancer hospital were retrospectively analyzed to explore the clinicopathological differences and prognostic factors between patients with and without endometriosis.Methods:The patients with OCCC and EAC in the Department of Gynecology of Shanxi cancer hospital from January 2012 to December 2019 were selected as the research objects.They were divided into EAOC group and non-EAOC group according to whether they were complicated with endometriosis.The clinical data of the patients were analyzed and compared,and the follow-up data were analyzed for survival.Results:1.The onset age of EAOC group was 46.64 ± 7.79 years old,which was lower than that of non-EAOC group 51.25 ± 9.21 years old(P = 0.004).Compared with non-EAOC group,EAOC group patients were more in premenopausal state(61.4% vs 40.2% P =0.019),fewer births(43.2% vs 25.5% P = 0.034),low CA125 level(68.86 ± 140.3 vs189.61 ± 460.73u/ml P = 0.018),low HE4 level(69.83 ± 64.54vs157.23 ± 230.01 pm P =0.001)With smaller tumor diameter(8.5vs10 cm,P = 0.003)and earlier clinical stage(88.6% vs73.5% P = 0.043),non-EAOC group showed more lower abdominal pain than EAOC group(9.1% vs25.5% P = 0.024).2.The 2-year disease-free survival rate in EAOC group was higher than that in non-EAOC group(90.91% vs 72.92% P = 0.016),but there was no significant difference in tumor recurrence,death and 2-year overall survival rate between the two groups(P >0.05).3.The presence or absence of endometriosis had no significant effect on OS and PFS of OCCC and EAC(P > 0.05).4.The important prognostic factors of OS in patients with OCCC and EAC included preoperative serum CA125 level,satisfactory tumor reduction surgery,FIGO stage and chemotherapy resistance.The results of multivariate analysis showed that preoperative serum CA125 level,FIGO stage and chemotherapy resistance were independent predictors of OS(P<0.05).Univariate analysis showed that the important factors affecting PFS were pregnancy,FIGO stage and chemotherapy resistance(P < 0.05).Cox regression analysis further confirmed that only chemotherapy resistance was the only independent predictor of PFS(P = 0.000).Conclusion:1.Whether OCCC and OEC are combined with endometriosis shows different clinicopathological features and prognosis.2.2.Compared with patients in the non-EAOC group,patients in the EAOC group had earlier onset age,more premenopausal,low CA125 level,low HE4 level,fewer pregnancies,smaller tumor diameter and earlier clinical stage.3.Compared with non-EAOC group,EAOC patients had a better prognosis in terms of 2-year progression free survival,but there was no significant difference in overall survival.4.endometriosis is not an independent factor affecting the prognosis of OCCC and EAC.