| Objectives 1.To review the clinical data of patients diagnosed with ovarian clear cell carcinoma(OCCC)and ovarian endometrioid adenocarcinoma(EAC),and analyze their clinical pathology and prognosis characteristics.2.To explore the clinical prognostic characteristics of patients with or without endometriosis including pre-operative information,surgical and pathological results.Methods 1.According to pathological types,patients who were diagnosed with OCCC and EAC after gynecological surgery from 2005 to 2015 at the Affiliated Hospital of Qingdao University were divided into two groups(OCCC group and EAC group).The clinical,surgical,and chemotherapy data were retrospectively analyzed and compared.Survival analysis was performed on follow-up data,Kaplan-Meier was used for univariate survival analysis,and Cox risk model was used for multivariate survival analysis.2.The two cancers were classified into endometriosis-associated ovarian cancer group(EAOC group)and non-endometriosis-associated ovarian cancer group(non-EAOC group)according to whether or not endometriosis was involved in their clinical,surgical,and chemotherapy The prognosis and other data were retrospectively analyzed and compared.Results 1.The average age in the OCCC group was 51.7±8.0 years,which was higher than that of the EAC group(48.1±8.1 years)(P=0.01).Compared with the EAC group,the OCCC group had a higher incidence of dysmenorrhea(36.8% vs 17.8%,P=0.034),more history of endometriosis(29.8% vs 8.9%,P=0.009),More clinical manifestations of bloating(33.3% vs 15.5%,P=0.041),lower preoperative CA125 levels(221±96.2 U/ml vs 711.1±1398.8 U/ml,P=0.003),more abdominal cavity Adhesions(86.0% vs 35.6%,P=0.000),more stage I lesions(50.9% vs 31.1%,P=0.045),and more poor differentiation(94.7% vs 68.8%,P=0.01).The EAC group had more irregular vaginal bleeding than the OCCC group(15.5% vs 3.5%,P=0.033),more bilateral onset(12.3% vs 37.8%,P=0.003),and more endometriosis Lesions(31.1% vs 7.0%,P=0.002),more highly differentiated(12.3 vs 1.8% P=0.042).In the OCCC group,15 patients were chemotherapeutic drug resistance,26.3%,and 4 patients were chemotherapeutic drug resistant in the EAC group(8.9%).There was more chemotherapy resistance in the OCCC group than in the EAC group(P=0.025).The median survival of the OCCC group was 64 months,and the median survival time of the EAC group was 67 months.The progression-free survival of the OCCC group was 47 months,and the progression-free survival of the EAC group was 50 months.The 2-year survival rate in the OCCC group was 78.4%,and the 2-year survival rate in the EAC group was 88.2%.The univariate survival results showed that there was a statistically significant difference in overall survival time with endometriosis,preoperative serum CA125 levels,tumor side malignancy,malignant ascites,satisfactory tumor reduction surgery,FIGO staging,and chemotherapy resistance.Multivariate survival analysis suggested that satisfactory tumor reduction,FIGO staging,and bilateral ovary involvement were independent prognostic factors for ovarian cancer.The P values were 0.013,0.009,and 0.027,respectively.2.The average age of onset in the EAOC and non-EAOC groups was 47.6±8.6 vs 50.6±10.7 years(P=0.042).Compared with non-EAOC group,EAOC group had more dysmenorrhea history(51.6% vs 24.0%,P=0.007),more history of endometriosis(40.7% vs 13.3%,P=0.003),lowerower delivery number(P=0.001),higher CA125 levels(618.2±1576.4 U/ml vs 369.2±747.1 U/ml,P=0.032),larger tumor diameters(13.6±5.0 cm vs 11.3±6.2 cm,P=0.048),earlier tumor stage(59.6% vs 36.0%,P=0.036).The median survival time was 79 months in the EAOC group and 54 months in the non-EAOC group.The 2-year survival rate in the EAOC group was 88.9% higher than that in the non-EAOC group(P=0.031).The progression-free survival time was 53 months in the EAOC group and 34 months in the non-EAOC group.The 2-year progression-free survival rate in the EAOC group was 64.1% higher than that in the non-EAOC group with a 2-year progression-free survival rate of 52.6%(P=0.048).Conclusions OCCC and EAC are closely related to internal heterogeneity and they have different clinical,pathological,and prognostic features.With or without endometriosis,preoperative serum CA125 levels,tumor sidelines,malignant ascites,satisfactory cytoreductive surgery,FIGO staging,and chemotherapy resistance were the significant prognostic factors associated with survival.Chemotherapy resistance,FIGO staging,and bilateral ovary involvement were independent factors of ovarian cancer.Patients with EOAC have a younger age of onset and a better overall prognosis.Older age,higher preoperative CA125 levels,larger tumor diameters,and longer history of endometriosis might be high risk factors for endometriosis of malignant transformation. |
