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Clinical outcomes of patients with endometrioid epithelial ovarian cancer following surgical treatment
Author(s) -
Cybulska Paulina,
Tseng Jill,
Zhou Qin C.,
Iasonos Alexia,
Delair Deborah F.,
Mueller Jennifer J.,
Long Roche Kara C.,
AbuRustum Nadeem R.,
Leitao Mario M.
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26597
Subject(s) - medicine , hazard ratio , endometrial cancer , stage (stratigraphy) , confidence interval , chemotherapy , endometriosis , retrospective cohort study , ovarian cancer , surgery , cancer , gynecology , paleontology , biology
Background Endometrioid epithelial ovarian cancer (EEOC) is rare, and its management poorly defined. We examined factors associated with 5‐year progression‐free survival (PFS) after surgery for EEOC. Methods Retrospective study: treatment and outcomes of all EEOC patients undergoing initial surgery at, or presenting to, our institution within 3 months of initial surgery, 1/2002‐9/2017. Results In total, 212 patients were identified. Median follow‐up, 63.9 months (range, 0.7–192); median age at diagnosis, 52 years (range, 20–88); disease stage: I, n = 145 (68%); II, n = 47 (22%); III/IV, n = 20 (9%); FIGO grade: 1, 127 (60%); 2, 66 (31%); 3, 17 (8%); unknown, 2 (1%). One hundred twenty‐eight (60%) had endometriosis; 75 (35%), synchronous endometrioid endometrial cancer (80%, IA); 101 (48%), complete surgical staging; 8 (5%), positive pelvic lymph nodes (LNs); 6 (4%), positive para‐aortic LNs; 176 (97%), complete gross resection; 123 (60%), postoperative chemotherapy; 56(28%), no additional treatment. Five‐year PFS, 83% (95% confidence interval [CI]: 76.6%–87.8%); 5‐year overall survival (OS), 92.7% (95% CI: 87.7%–95.8%). Age, stage, and surgical staging were associated with improved 5‐year PFS, and younger age at diagnosis with improved 5‐year OS ( p < 0.001). Chemotherapy did not improve 5‐year PFS in IA/IB versus observation, but improved survival in IC (hazard ratio [HR]: 1.01, 95% CI: 0.22–4.59, p = 0.99; HR: 0.17, 95% CI: 0.04–0.7, p = 0.006). Conclusions Age, stage, and full surgical staging were associated with improved 5‐year PFS. Chemotherapy showed no benefit in IA/IB disease.