Clinical Analysis Of Synchronous Primary Endometrial And Ovary Cancer

Objective:To investigate the incidence of synchronous primary endometrial and ovary cancer in endometrial cancer.To compare the clinical features,histopathological features,endometrial thickness,ovarian tumor diameter and survival time between SEOC patients with same histopathological type of endometrioid adenocarcinoma and SEOC patients with different histopathological types.Methods:Retrospective analysis of the clinical data of 64 patients of SEOC who underwent primary surgery in the Affiliated Hospital of Qingdao University from January 2003 to January 2017.There are 36 SEOC patients with the same histopathologic types of endometrioid adenocarcinoma in 64 SEOC patients(Group A),different histopathological types of 28 patients with SEOC(Group B).The clinical data of patients with SEOC in group A and group B were compared: age,preoperative CA125 level,endometrial thickness,ovarian tumor diameter,histopathological features and survival time,Whether it has statistical significance or not.SPSS 16.0 software is used in the statistical analysis of the data in this study.Results:1.There were 3982 patients of endometrial cancer who were diagnosed and treated from January 2003 to January 2017 in the affiliated Hospital of Qingdao University.There were 64 SEOC patients in 3982 patients of endometrial cancer.The main finding of this study is that the incidence of SEOC in endometrial cancer during the same period is 1.6%.2.The main clinical symptoms of 90.7% SEOC patients are abnormal vaginal bleeding,vaginal fluid,abdominal pain,abdominal distention.In contrast,there were no clinical symptoms in 9.3% SEOC patients,who were found during routine physical examination.The median age at the time of diagnosis was 49.7 years(range 22 to 66years).65.6% of patients had unmenopausal who were found,34.4% of patients had menopause.The median CA125 levels at the time of diagnosis was 713.3 IU/ mL(range15.97 to 4327 IU/ mL),the 84.6% patients of SEOC CA125 levels were increased.The 64 patients of SEOC median endometrial thickness was 1.4cm(range 0.2 to 3.7 cm).The median ovarian cancer diameter 10.0 cm(range 0 to 21 cm).3.56.3% of SEOC patients histopathological type was endometrioid adenocarcinoma.87.5% of endometrial cancer in 64 SEOC patients the histopathologictype was endometrial adenocarcinoma.59.4%of ovarian cancer the histopathological type was ovarian endometrioid adenocarcinoma.89.1% of endometrial cancer had high differentiation and moderate differentiation in 64 patients of SEOC,85.9% of ovarian cancer have high differentiation and moderate differentiation.95.3% of endometrial cancer was stage ?-?,90.6% of ovarian cancer was stage ?-?.65.6% SEOC both endometrial cancer and ovarian cancer were stage I.40.6%SEOC patients underwent total abdominal hysterectomy,bilateral salpingooophorectomy,omentectomy,and bilateral pelvic lymph node dissection.53.1% SEOC patients underwent total abdominal hysterectomy,bilateral salpingooophorectomy,omentectomy,bilateral pelvic lymph node dissection and paraaortic lymph node dissection.6.3% SEOC patients underwent total abdominal hysterectomy,bilateral salpingooophorectomy,omentectomy,bilateral pelvic lymph node dissection,paraaortic lymph node dissection and appendectomy.All patients underwent complete surgical staging procedure.54 patients of SEOC had received combination chemotherapy based on platinum chemotherapy.10 patients had no received adjuvant therapy.4.64 patients of SEOC has follow-up time range 12 to 168 months,The median survival time 108.4 ±45.5 months,the 5-year and 10-year overall survival rates were82.8% and 57.8%,respectively.The overall survival time of SEOC patients in group A was 116.3 ± 48.0 months,the 5-year and 10-year survival rates were 86.1% and 69.4%,respectively.The overall survival time of SEOC patients in group B was 85.7 ±45.5months,the five-year and 10-year survival rates were 78.5% and 42.9%,respectively.The survival time of SEOC patients in group A was significantly longer than that in group B,the age of onset in group A is less than that in group B,the diameter of ovarian tumor in group A is larger than that in group B.The age of onset,the ovarian tumor diameter and the survival time of SEOC patients in group A and B were significantly different(P <0.05).The thickness of endometrium and the level of CA125 before operation were compared(P > 0.05),the difference was not statistically significant.Conclusions:1.The main clinical manifestations of 64 patients of SEOC are abnormal vaginal bleeding,vaginal fluid,abdominal pain and abdominal distension.The average age of onset of SEOC is younger,and most of the patients are not menopausal at the time of onset.Preoperative CA125 increase,endometrial thickening,ovarian lesionsof 64 patients of SEOC.2.In this study,the main histopathological types of SEOC patients are endometrial adenocarcinoma.The histopathological differentiation of most patients with SEOC is good,most of them are high and moderate differentiation.The pathological stage of operation is earlier,most of who are I-II stage.Although SEOC patients are concurrentmalignant tumors of two sites,their prognosis is generally good.3.The prognosis of group A is better than group B,The age of onset in group A is less than that in group B,The diameter of ovarian tumor in group A is larger than that in group B,the difference is statistically significant(P < 0.05).