Ovarian Cancer Survival in the presence of Endometriosis

Women with ovarian cancer and endometriosis have longer overall survival, study finds.

Key Points

Highlights: 

• Women with ovarian cancer and endometriosis have longer overall survival compared to women with ovarian cancer alone.

Importance:

• Future studies on women with ovarian cancer treatment should consider the concurrent endometriosis status.

What's done here:

• Researchers conducted a retrospective nationwide cohort study in a Dutch population which includes more than thirty thousand people.

Key results:

• 6.1% of women diagnosed with ovarian cancer between 1990 and 2015 also had endometriosis.
• 81.2% of women who had both diseases received a diagnosis at the same time.
• Women with ovarian cancer who also had endometriosis were younger at the time of diagnosis, had more favorable tumor characteristics, and more often had surgery to treat cancer.
• Women with ovarian cancer and endometriosis have a better prognosis.

Limitations:

• The findings could not be adjusted for hormonal therapies, obstetrical history, or other possible confounders.
• Women in the control cohort could have had a clinical endometriosis diagnosis and be wrongly assigned to the control group.
• No information was available on cancer recurrence or whether recurrence was different between patients with and without endometriosis.
• It could not be verified whether all the endometriosis cases met the criteria for endometriosis-associated ovarian cancer as defined by Sampson et al.

Lay Summary

Women with ovarian cancer and histologically proven endometriosis have longer overall survival compared to those with ovarian cancer but no endometriosis, found a study published in the American Journal of Obstetrics & Gynecology. 

“[…] Women diagnosed as having ovarian cancer and concurrent endometriosis should be explained the role of endometriosis in ovarian cancer survival,” the authors of the study wrote. They added that future studies on the treatment and prognosis of ovarian cancer should consider stratifying patients by endometriosis status to better understand the role of the condition.

In order to evaluate the survival rate in women with ovarian cancer with or without histologically proven endometriosis, a team of researchers led by Professor Ruud L M Bekkers conducted a retrospective nationwide cohort study. 

First, they identified all women from the Netherlands Cancer Registry with ovarian cancer diagnosed between 1990 and 2015. Then, they linked these women with the Dutch nationwide registry of histopathology and cytopathology to identify those with histologically proven endometriosis. Finally, they compared the prognosis of women with ovarian cancer with and without endometriosis.

The results showed that of 32,419 women with ovarian cancer, 1979 (6.1%) also had endometriosis. The majority (81.2%) of women who had both diseases received a diagnosis at the same time.

Women with ovarian cancer and endometriosis were younger when they received a diagnosis of ovarian cancer compared to those without endometriosis. They also had more favorable tumor characteristics. Finally, they more often had surgical treatment for ovarian cancer.

Using statistical analyses, the researchers concluded that women with endometriosis had a significantly better prognosis than those without endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/32841629/