open access

Vol 92, No 9 (2021)
Research paper
Published online: 2021-08-06
Get Citation

Metastatic and synchronous ovarian involvement in low-risk endometrial cancer; clinicopathological analysis with detection of DNA mismatch repair deficiency

Şener Gezer1, Büşra Yaprak Bayrak2
DOI: 10.5603/GP.a2021.0150
·
Pubmed: 34541641
·
Ginekol Pol 2021;92(9):599-606.
Affiliations
  1. Department of Gynecologic Oncology, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey
  2. Department of Pathology, Kocaeli University School of Medicine, Umuttepe, Kocaeli, Turkey

open access

Vol 92, No 9 (2021)
ORIGINAL PAPERS Gynecology
Published online: 2021-08-06

Abstract

Objectives: This study aimed to investigate ovarian involvement in low-risk endometrial cancer, the associated risk factors, and impact on overall survival. We attempted to explore the differences in mismatch repair (MMR) deficiency between metastatic and synchronous ovarian tumoral involvement.
Material and methods: This was a retrospective study of patients with low-risk endometrial cancer who were treated at a tertiary center between January 2006 and December 2019. The primary outcome measures were the incidence and risk factors associated with metastatic and synchronous tumoral involvement of the ovary. Overall, survival data were also analyzed. Metastatic and synchronous tumors were compared with each other in terms of MMR deficiency with IHC staining.
Results: From a total of 360 low-risk endometrial cancer patients, 10 (2.8%) had ovarian metastasis and 12 (3.3%) had synchronous ovarian involvement. The median age of patients with metastasis was significantly lower than that of patients without ovarian involvement (49 vs 57 years, p = 0.004). Most patients in the metastatic group were in the < 50 age group (p < 0.001) and premenopausal period (p = 0.001). As a result of IHC staining performed on patients with ovarian involvement, MMR deficiency was found in six (60%) patients in the metastatic group and six (50%) patients in the synchronous group. No significant difference was found in overall survival between groups.
Conclusions: Younger age and premenopausal status were risk factors associated with ovarian metastasis. Overall survival did not show differences between all groups, and MMR deficiency was similar between metastatic and synchronous groups.

Abstract

Objectives: This study aimed to investigate ovarian involvement in low-risk endometrial cancer, the associated risk factors, and impact on overall survival. We attempted to explore the differences in mismatch repair (MMR) deficiency between metastatic and synchronous ovarian tumoral involvement.
Material and methods: This was a retrospective study of patients with low-risk endometrial cancer who were treated at a tertiary center between January 2006 and December 2019. The primary outcome measures were the incidence and risk factors associated with metastatic and synchronous tumoral involvement of the ovary. Overall, survival data were also analyzed. Metastatic and synchronous tumors were compared with each other in terms of MMR deficiency with IHC staining.
Results: From a total of 360 low-risk endometrial cancer patients, 10 (2.8%) had ovarian metastasis and 12 (3.3%) had synchronous ovarian involvement. The median age of patients with metastasis was significantly lower than that of patients without ovarian involvement (49 vs 57 years, p = 0.004). Most patients in the metastatic group were in the < 50 age group (p < 0.001) and premenopausal period (p = 0.001). As a result of IHC staining performed on patients with ovarian involvement, MMR deficiency was found in six (60%) patients in the metastatic group and six (50%) patients in the synchronous group. No significant difference was found in overall survival between groups.
Conclusions: Younger age and premenopausal status were risk factors associated with ovarian metastasis. Overall survival did not show differences between all groups, and MMR deficiency was similar between metastatic and synchronous groups.

Get Citation

Keywords

low-risk endometrial cancer; ovarian involvement; ovarian metastasis; synchronous ovarian cancer

About this article
Title

Metastatic and synchronous ovarian involvement in low-risk endometrial cancer; clinicopathological analysis with detection of DNA mismatch repair deficiency

Journal

Ginekologia Polska

Issue

Vol 92, No 9 (2021)

Article type

Research paper

Pages

599-606

Published online

2021-08-06

DOI

10.5603/GP.a2021.0150

Pubmed

34541641

Bibliographic record

Ginekol Pol 2021;92(9):599-606.

Keywords

low-risk endometrial cancer
ovarian involvement
ovarian metastasis
synchronous ovarian cancer

Authors

Şener Gezer
Büşra Yaprak Bayrak

References (35)
  1. Lin KY, Miller DS, Bailey AA, et al. Ovarian involvement in endometrioid adenocarcinoma of uterus. Gynecol Oncol. 2015; 138(3): 532–535.
  2. Ignatov T, Eggemann H, Burger E, et al. Ovarian metastasis in patients with endometrial cancer: risk factors and impact on survival. J Cancer Res Clin Oncol. 2018; 144(6): 1103–1107.
  3. AlHilli MM, Dowdy SC, Weaver AL, et al. Incidence and factors associated with synchronous ovarian and endometrial cancer: a population-based case-control study. Gynecol Oncol. 2012; 125(1): 109–113.
  4. Walsh C, Holschneider C, Hoang Y, et al. Coexisting ovarian malignancy in young women with endometrial cancer. Obstet Gynecol. 2005; 106(4): 693–699.
  5. Gemer O, Bergman M, Segal S. Ovarian metastasis in women with clinical stage I endometrial carcinoma. Acta Obstet Gynecol Scand. 2004; 83(2): 208–210.
  6. Akbayır O, Kuru O, Goksedef P, et al. Coexisting ovarian malignancy in patients with clinical stage I endometrial carcinoma. Arch Gynecol Obstet. 2012; 286(5): 1241–1245.
  7. Soliman PT, Broaddus RR, Schmeler KM, et al. Women with synchronous primary cancers of the endometrium and ovary: do they have Lynch syndrome? J Clin Oncol. 2005; 23(36): 9344–9350.
  8. Ramus SJ, Elmasry K, Luo Z, et al. Predicting clinical outcome in patients diagnosed with synchronous ovarian and endometrial cancer. Clin Cancer Res. 2008; 14(18): 5840–5848.
  9. Batte BAL, Bruegl AS, Daniels MS, et al. Consequences of universal MSI/IHC in screening ENDOMETRIAL cancer patients for Lynch syndrome. Gynecol Oncol. 2014; 134(2): 319–325.
  10. Schultheis AM, Ng CKY, De Filippo MR, et al. Massively Parallel Sequencing-Based Clonality Analysis of Synchronous Endometrioid Endometrial and Ovarian Carcinomas. J Natl Cancer Inst. 2016; 108(6): djv427.
  11. Anglesio MS, Wang YiK, Maassen M, et al. Synchronous Endometrial and Ovarian Carcinomas: Evidence of Clonality. J Natl Cancer Inst. 2016; 108(6): djv428.
  12. Scully RE, Young RH, Clement PB. Tumors of the Ovary, Maldeveloped Gonads, Fallopian Tube, and Broad Ligament. Armed Forces Institute of Pathology, Washington 1998.
  13. Zaino R, Whitney C, Brady MF, et al. Simultaneously detected endometrial and ovarian carcinomas--a prospective clinicopathologic study of 74 cases: a gynecologic oncology group study. Gynecol Oncol. 2001; 83(2): 355–362.
  14. Soliman PT, Slomovitz BM, Broaddus RR, et al. Synchronous primary cancers of the endometrium and ovary: a single institution review of 84 cases. Gynecol Oncol. 2004; 94(2): 456–462.
  15. Oranratanaphan S, Manchana T, Sirisabya N. Clinicopathologic variables and survival comparison of patients with synchronous endometrial and ovarian cancers versus primary endometrial cancer with ovarian metastasis. Asian Pac J Cancer Prev. 2008; 9(3): 403–407.
  16. Juhasz-Böss I, Fehm T, Becker S, et al. Endometrial Cancer: Comparison of Patients with Synchronous Primary Carcinoma of the Endometrium and Ovary vs. Endometrial Carcinoma with Ovarian Metastases. Geburtshilfe Frauenheilkd. 2012; 72(8): 721–726.
  17. Matsuo K, Machida H, Stone RL, et al. Risk of Subsequent Ovarian Cancer After Ovarian Conservation in Young Women With Stage I Endometrioid Endometrial Cancer. Obstet Gynecol. 2017; 130(2): 403–410.
  18. Modaress MG, Cheraghi F, Zamani N. Ovarian metastasis in endometriod type endometrial cancer. Int J Fertil Steril. 2011; 5(3): 148–151.
  19. Bese T, Sal V, Kahramanoglu I, et al. Synchronous Primary Cancers of the Endometrium and Ovary With the Same Histopathologic Type Versus Endometrial Cancer With Ovarian Metastasis: A Single Institution Review of 72 Cases. Int J Gynecol Cancer. 2016; 26(2): 394–406.
  20. Chiang YC, Chen CA, Huang CY, et al. Synchronous primary cancers of the endometrium and ovary. Int J Gynecol Cancer. 2008; 18(1): 159–164.
  21. Williams MG, Bandera EV, Demissie K, et al. Synchronous primary ovarian and endometrial cancers: a population-based assessment of survival. Obstet Gynecol. 2009; 113(4): 783–789.
  22. Ayhan A, Guvenal T, Coskun F, et al. Survival and prognostic factors in patients with synchronous ovarian and endometrial cancers and endometrial cancers metastatic to the ovaries. Eur J Gynaecol Oncol. 2003; 24(2): 171–174.
  23. Heitz F, Amant F, Fotopoulou C, et al. Synchronous ovarian and endometrial cancer--an international multicenter case-control study. Int J Gynecol Cancer. 2014; 24(1): 54–60.
  24. Reijnen C, Küsters-Vandevelde HVN, Ligtenberg MJL, et al. Molecular profiling identifies synchronous endometrial and ovarian cancers as metastatic endometrial cancer with favorable clinical outcome. Int J Cancer. 2020; 147(2): 478–489.
  25. Murphy MA, Wentzensen N. Frequency of mismatch repair deficiency in ovarian cancer: a systematic review This article is a US Government work and, as such, is in the public domain of the United States of America. Int J Cancer. 2011; 129(8): 1914–1922.
  26. Shikama A, Minaguchi T, Matsumoto K, et al. Clinicopathologic implications of DNA mismatch repair status in endometrial carcinomas. Gynecol Oncol. 2016; 140(2): 226–233.
  27. Gordhandas S, Kahn RM, Gamble C, et al. Clinicopathologic features of endometrial cancer with mismatch repair deficiency. Ecancermedicalscience. 2020; 14: 1061.
  28. Kobayashi Y, Nakamura K, Nomura H, et al. Clinicopathologic analysis with immunohistochemistry for DNA mismatch repair protein expression in synchronous primary endometrial and ovarian cancers. Int J Gynecol Cancer. 2015; 25(3): 440–446.
  29. Aysal A, Karnezis A, Medhi I, et al. Ovarian endometrioid adenocarcinoma: incidence and clinical significance of the morphologic and immunohistochemical markers of mismatch repair protein defects and tumor microsatellite instability. Am J Surg Pathol. 2012; 36(2): 163–172.
  30. McConechy MK, Talhouk A, Li-Chang HH, et al. Detection of DNA mismatch repair (MMR) deficiencies by immunohistochemistry can effectively diagnose the microsatellite instability (MSI) phenotype in endometrial carcinomas. Gynecol Oncol. 2015; 137(2): 306–310.
  31. Kim SR, Pina A, Albert A, et al. Mismatch repair deficiency and prognostic significance in patients with low-risk endometrioid endometrial cancers. Int J Gynecol Cancer. 2020; 30(6): 783–788.
  32. Kim SR, Pina A, Albert A, et al. Does MMR status in endometrial cancer influence response to adjuvant therapy? Gynecol Oncol. 2018; 151(1): 76–81.
  33. Backes FJ, Haag J, Cosgrove CM, et al. Mismatch repair deficiency identifies patients with high-intermediate-risk (HIR) endometrioid endometrial cancer at the highest risk of recurrence: A prognostic biomarker. Cancer. 2019; 125(3): 398–405.
  34. Yoneoka Y, Yoshida H, Ishikawa M, et al. Prognostic factors of synchronous endometrial and ovarian endometrioid carcinoma. J Gynecol Oncol. 2019; 30(1): e7.
  35. Hájková N, Tichá I, Hojný J, et al. Synchronous endometrioid endometrial and ovarian carcinomas are biologically related: A clinico-pathological and molecular (next generation sequencing) study of 22 cases. Oncol Lett. 2019; 17(2): 2207–2214.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl