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189 Endometriosis and ovarian cancer: related or associated? Exploring differences and similarities
  1. Giulia Dondi1,
  2. Camelia Alexandra Coada2,
  3. Marco Di Stanislao1,3,
  4. Francesco Mezzapesa1,3,
  5. Antonio De Leo3,4,
  6. Lidia Strigari5,
  7. Stella Di Costanzo1,
  8. Gloria Ravegnini6,
  9. Miriam Santoro5,
  10. Dario De Biase4,7,
  11. Vladislav Zybin8,
  12. Luigi Lovato8,
  13. Pierandrea De Iaco1,3 and
  14. Anna Myriam Perrone1,3
  1. 1Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
  2. 2Faculty of Medicine, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca
  3. 3Romania
  4. 4Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
  5. 5Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  6. 6Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  7. 7Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
  8. 8Department of Pharmacy and Biotechnology (FaBit), University of Bologna, Bologna, Italy
  9. 9Pediatric and Adult CardioThoracic and Vascular, Onchoematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy


Introduction/Background Endometriosis-associated ovarian carcinoma (EAOC) and endometriosis-related ovarian cancer (EROC) are relatively underexplored conditions characterized by the coexistence of ovarian carcinoma (OC) and endometriosis. The main distinction between them lies in the presence of transitional borderline lesions, observed in EROC but absent in EAOC. The aim of this study was to investigate and elucidate the differences among EROC, EAOC, and OC not related or associated with endometriosis (NEOC).

Methodology This prospective, observational, monocentric study, funded by the Italian Ministry of Health (ENDO-2021–12371926), enrolled 94 patients with OC undergoing surgery (November 2021-June 2023). The correlation between endometriosis and OC was assessed by expert pathologists, categorizing patients into three groups: EROC, EAOC, and NEOC. Clinical, surgical, and pathological data were analyzed.

Results Out of 94 patients, 48 (51%) were diagnosed with NEOC, 17 (18%) with EAOC, and 29 (31%) with EROC. Average age at diagnosis was lower in EROC and EAOC (57 and 61 years) compared to NEOC (65 years). Ultrasound assessments showed that EROC and EAOC were mainly unilateral compared to NEOC (66.7% and 69%, vs 41.3%) and lacked free fluid in the pouch of Douglas (69% and 88.2%, vs 52.1% in NEOC). EROC featured a greater endometrial thickness (mean 8 mm) compared to EAOC and NEOC (<5 mm), in fact endometrial pathology was more frequent in EROC (48% of cases) compared to EAOC and NEOC (17.6% and 10.5%). CA-19.9 levels were higher in EROC (mean 756 U/ml) compared to other groups (<30 U/ml). EROC was predominantly diagnosed at initial FIGO stage (I-II) (75.8%), with respect to EAOC and NEOC (29.4% and 25%). The most common histotypes in EROC included clear-cell, endometrioid, and mesonephric-like adenocarcinomas.

Conclusion EROC and EAOC exhibit distinct clinical and histopathological characteristics. EAOC emerges as a distinct entity with mixed characteristics bridging the features of EROC and NEOC.

Disclosures The study is funded by the Italian Ministry of Health (ENDO-2021–12371926).

Abstract 189 Table 1

Characteristics of patients diagnosed with NEOC, EAOC and EROC.

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