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Abstract
Introduction/Background Treatment of women with synchronous cancers arising in the endometrium and adnexa remains a clinical challenge. An unambiguous identification of the disease origin is not always possible but this impacts on staging and therapeutic options in the frontline- maintenance and relapsed setting. Phenotypical and genotypical characteristics of endometrioid and serous gynaecological carcinomas overlap independent of the primary site and we here aimed to study the clinico-pathologic characteristics of these patients and the adherence to treatment patterns.
Methodology This single-center, retrospective cohort study reviewed cases treated for synchronous endometrioid and serous cancers between 2006 and 2021 at Oslo University Hospital, Norway. Clinicopathologic characteristics and data on treatment were derived from the institutional quality assurance database.
Results A total of 70 cases were identified. Synchronous endometrioid cancers (n=41, 59%) showed a high level of concordance of grade of differentiation and were associated with the presence of endometriosis or adenomyosis in 19 (46%) of the cases. Recommendations for adjuvant treatment were varying. Serous carcinomas n=14 (20%) were regularly disseminated at the time of diagnosis n=6 (43%) and treated with platinum-based chemotherapy. A third group n=14 (20%) was diagnosed with low-grade intrauterine endometrioid carcinomas and serous adnexal carcinomas.
Conclusion Our study confirms the association of synchronous endometrioid cancers with endometriosis and highlights the need to examine the underlying mechanisms of malignant transformation of endometriosis. There were distinct differences in patters of spread dependent on histology. Synchronous serous carcinoma may represent disseminated disease from the same origin and this warrants investigations of clonality.
Disclosures The authors declare no conflict of interest.
