Khalid Nazish, Ullah Faizan, Zafar Hania, Anwer Abdul Wahid, Abbas Taskheer, Shakeel Osama, Faisal Muhammad, Sadaf Tabinda, Syed Aamir Ali
Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Obstetrics and Gynecology, The Indus Hospital, Lahore, PAK.
Cureus. 2020 Jul 13;12(7):e9163. doi: 10.7759/cureus.9163.
Background and objective The incidence of synchronous primary endometrial and ovarian cancer is uncommon and poses a diagnostic challenge to the treating physician about their origin as either primary or metastasis. The purpose of this study was to evaluate the clinicopathological behavior, treatment modality-related outcomes, and prognosis related to primary endometrial and ovarian cancers at a tertiary care referral center in South Asia. Methods We retrospectively analyzed 30 patients with synchronous ovarian and endometrial cancers treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore, Pakistan from January 2005 to August 2017. Results The median age of the patients at the time of diagnosis was 51 years (range: 25-72 years). The common presenting symptoms were irregular uterine bleeding (30%), post-menopausal bleeding (26.7%), abdominal mass (16.7%), and abdominal pain (26.7%). Endometrial adenocarcinoma type was the most common histological variant found among the participants: 90% (n=27) of uterine and 56.7% (n=17) of ovarian cancers. All patients underwent surgical intervention. Among them, 25 patients received platinum-based adjuvant chemotherapy, four received neoadjuvant chemotherapy, and 18 received adjuvant radiotherapy. The early-stage group [International Federation of Gynecology and Obstetrics (FIGO) stage I and II] had a more favorable prognosis than the advanced stage group (FIGO stages III and IV). Conclusion Based on our findings, patients with synchronous primary endometrial and ovarian cancers have better overall survival rates than patients with single primary ovarian or endometrial cancers. Also, synchronous primary endometrial and ovarian cancer endometroid types have better overall survival than patients with non-endometrioid or mixed histologic types.
背景与目的 同时性原发性子宫内膜癌和卵巢癌的发病率并不常见，给治疗医生在判断其起源是原发性还是转移性方面带来了诊断挑战。本研究的目的是在南亚一家三级医疗转诊中心评估原发性子宫内膜癌和卵巢癌的临床病理行为、与治疗方式相关的结局以及预后。方法 我们回顾性分析了2005年1月至2017年8月在巴基斯坦拉合尔的绍卡特·汗姆纪念癌症医院和研究中心接受治疗的30例同时性卵巢癌和子宫内膜癌患者。结果 患者诊断时的中位年龄为51岁（范围：25 - 72岁）。常见的临床表现为不规则子宫出血（30%）、绝经后出血（26.7%）、腹部肿块（16.7%）和腹痛（26.7%）。子宫内膜腺癌是参与者中最常见的组织学类型：子宫癌患者中90%（n = 27）、卵巢癌患者中56.7%（n = 17）为该类型。所有患者均接受了手术干预。其中，25例患者接受了铂类辅助化疗，4例接受了新辅助化疗，18例接受了辅助放疗。早期组[国际妇产科联盟（FIGO）I期和II期]的预后比晚期组（FIGO III期和IV期）更有利。结论 根据我们的研究结果，同时性原发性子宫内膜癌和卵巢癌患者的总生存率高于单一原发性卵巢癌或子宫内膜癌患者。此外，同时性原发性子宫内膜癌和卵巢癌的子宫内膜样类型患者的总生存率高于非子宫内膜样或混合组织学类型的患者。
