Highlights
- •Patients with endometrioid ovarian cancer are more often diagnosed at early stage.
- •They are also younger, present more Lynch syndrome-associated cancers.
- •Endometrioid tumors are more frequently dMMR/MSI-high but have less BRCA1/2 mutations.
- •Endometrioid histology is independently associated with better PFS and OS.
Abstract
Background
Prognostic significance of endometrioid epithelial ovarian cancer (EOC) is controversial.
We compared clinical, pathological, and biological features of patients with endometrioid
and serous EOC, and assessed the independent effect of histology on outcomes.
Methods
We conducted a multicenter retrospective analysis of patients with EOC selected from
the French Epidemiological Strategy and Medical Economics OC database between 2011
and 2016. Our main objective was to compare overall survival (OS) in endometrioid
and serous tumors of all grades. Our second objectives were progression-free survival
(PFS) and prognostic features.
Results
Out of 10,263 patients included, 3180 cases with a confirmed diagnosis of serous (N = 2854) or endometrioid (N = 326) EOC were selected. Patients with endometrioid histology were younger, more
often diagnosed at an early stage, with lower-grade tumors, more frequently dMMR/MSI-high,
and presented more personal/familial histories of Lynch syndrome-associated cancers.
BRCA1/2 mutations were more frequently identified in the serous population. Endometrioid
patients were less likely to receive chemotherapy, with less bevacizumab. After median
follow-up of 51.7 months (95CI[50.1–53.6]), five-year OS rate was 81% (95CI[74–85])
in the endometrioid subgroup vs. 55% (95CI[53–57] in the serous subset (p < 0.001, log-rank test). In multivariate analyses including [age, ECOG-PS, FIGO,
grade, and histology], the endometrioid subtype was independently associated with
better OS (HR = 0.38, 95CI[0.20–0.70], p = 0.002) and PFS (HR = 0.53, 95CI[0.37–0.75], p < 0.001).
Conclusions
Clinicopathological features at diagnosis are not the same for endometrioid and serous
EOC. Endometrioid histology is an independent prognosis factor in EOC. These observations
suggest the endometrioid population requires dedicated clinical trials and management.
Keywords
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Article info
Publication history
Published online: July 19, 2021
Accepted:
July 11,
2021
Received in revised form:
July 8,
2021
Received:
May 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
