Predicting clinical outcome in patients diagnosed with synchronous ovarian and endometrial cancer.


Ramus, SJ; Elmasry, K; Luo, Z; Gammerman, A; Lu, K; Ayhan, A; Singh, N; McCluggage, WG; Jacobs, IJ; Whittaker, JC; Gayther, SA; (2008) Predicting clinical outcome in patients diagnosed with synchronous ovarian and endometrial cancer. Clinical cancer research, 14 (18). pp. 5840-8. ISSN 1078-0432 DOI: https://doi.org/10.1158/1078-0432.CCR-08-0373

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Abstract

PURPOSE: Patients with synchronous ovarian and endometrial cancers may represent cases of a single primary tumor with metastasis (SPM) or dual primary tumors (DP). The diagnosis given will influence the patient's treatment and prognosis. Currently, a diagnosis of SPM or DP is made using histologic criteria, which are frequently unable to make a definitive diagnosis. EXPERIMENTAL DESIGN: In this study, we used genetic profiling to make a genetic diagnosis of SPM or DP in 90 patients with synchronous ovarian/endometrial cancers. We compared genetic diagnoses in these patients with the original histologic diagnoses and evaluated the clinical outcome in this series of patients based on their diagnoses. RESULTS: Combining genetic and histologic approaches, we were able make a diagnosis in 88 of 90 cases, whereas histology alone was able to make a diagnosis in only 64 cases. Patients diagnosed with SPM had a significantly worse survival than patients with DP (P = 0.002). Patients in which both tumors were of endometrioid histology survived longer than patients of other histologic subtypes (P = 0.025), and patients diagnosed with SPM had a worse survival if the mode of spread was from ovary to endometrium rather than from endometrium to ovary (P = 0.019). CONCLUSIONS: Genetic analysis may represent a powerful tool for use in clinical practice for distinguishing between SPM and DP in patients with synchronous ovarian/endometrial cancer and predicting disease outcome. The data also suggest a hitherto uncharacterized level of heterogeneity in these cases, which, if accurately defined, could lead to improved treatment and survival.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 18794095
Web of Science ID: 259347600028
URI: http://researchonline.lshtm.ac.uk/id/eprint/7070

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