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Background  To analyze the clinical characteristics and chemo-resistance related factors of patients with resistant and non-resistant endometriosis-associated ovarian cancer (ovarian clear cell carcinoma and endometrioid carcinoma) by reviewing the data of epithelial ovarian cancer patients who received initial treatment in our hospital over a 12-year period.    Results  Among the 304 patients, 17.1% were seen with platinum-based drug resistance. The ROC curve of continuous variables was drawn according to resistance situation, then they were grouped by age (< 48 or ≥ 48 years), tumor size (< 7 cm or ≥ 7 cm) and Ca125 (< 90 and ≥ 90 U/ml). In univariate analysis, age ≥ 48 years, initial symptom of abdominal distension or weight loss, abnormal preoperative serum Ca125, Ca125 < 90 U/ml, advanced FIGO stage, absence of endometriosis, bilateral tumors, lack of lymphadenectomy, positive lymph nodes, unsatisfactory initial cytoreduction surgery and history of breast cancer were all related to drug resistance in ovarian cancer. In multivariate analysis, advanced stage, lack of lymphadenectomy, positive lymph nodes and history of breast cancer were independent risk factors related to platinum-based drug resistance ( P  < 0.05).    Conclusion  For patients of endometriosis-related ovarian cancer, platinum-based drug resistance were associated with advanced FIGO stage, lack of lymphadenectomy, positive lymph nodes and history of breast cancer.

Clinical analysis of chemo-resistance risk factors in endometriosis associated ovarian cancer