Analysis Of The Relationship Between Endometriosis And Ovarian Cancer

Objectives The study to explore the incidence,high risk factors and prognostic factors of ovarian endometriosis-related cancer by analyzing the cases of ovary cancer with endometriosis.Methods 1. General clinical data analysis:257 primary malignant ovarian tumors cases from 2007.1 to 2015.1 were comparative analyzed retrospectively. Among the 257 cases,25 were found to originate from endometriosis(group A),32 had CO-existing ovarian endometriosis(group B),and the remaining 200 had no ovarian endometriosis at all(group C). 2. Survival analysis:Group A and B were combined and collectively referred to as EMs-related ovarian cancer(EAOC).A retrospective analysis of 57 cases with EAOC were conducted. The log-rank test was used to assess independent factors of the prognosis for EAOC.Results 1. Clinical data:(1)The incidence rate of EAOC was 3.6%,and there were 25 cases of ovarian cancer with malignant transformation of endometriosis(1.6%) in all cases;(2)The mean age of the 57 EAOC patients was(46.3±15.1)years old,it was lower than group C,P<0.05;(3)Level of CA125:Three groups had high level of serum CA125;(4)Size of tumor:Tumor sizes were more than 10 cm in three groups,such as group A had16 cases(16/25,64%),group B had 22 cases(22/32,68.8%),and group C had 162 cases(162/200,81.0%);(5)First clinical signs:The major first clinical signs were lower abdominal pain in group A and group B(33/57,57.8%),but the major initial manifestation of group C were pelvic mass;(6)FIGO:The incidence of pathology?stage in group A?B was 68.0% and 56.3%,but pathology ? stage in group C was 56.0%;(7)pathological type:The main subtypes in group A?B were clear cell carcinoma,but it was serous adenocarcinoma in group C. 2.Survival analysis:(1)The mean survival time of 57 EAOC patients was(23.7±18.5) months,but the 1year,3 year and 5 year survival rates respectively were 71.9%,21.1% and 7.0%;(2)The survival time of age less than 50 years old in patients was much higher than patients with greater than 50 years old(P<0.01);(3)FIGO stage:Prognosis was much poorer in advanced stage(?/?stage) of EAOC patients(P=0.048);(4) Postoperative tumor residual:Prognosis was much better in the smaller ones(P=0.008);(5) Level of CA125:The survival time was much longer in the low level(P<0.01);(6) Chemotherapy:Patients with less than 6 cycles had poorer prognosis than those with more than 6 cycles(P<0.01),but prognosis was much better in patients with TCM nursing.Conclusions 1. There was a certain probability of malignancy in ovarian endometriosis,and the histological type of EAOC was mainly clear cell carcinoma,and the phase II was majority in FIGO stage. But they were considered to be high risk factors for malignant transformation,which including age,serum CA125 level>200 U/m L and the diameter of tumor >10 cm. 2. Age,preoperative CA125 level,postoperative tumor residual,chemotherapy treatment and reasonable standard of TCM nursing are associated with prognosis of EAOC patients.