Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis

Background Whether endometriosis affects the prognosis of ovarian clear cell carcinoma (OCCC) remains controversial despite the relationship between OCCC and endometriosis. A two-center cohort study and meta-analysis were performed to investigate the effect of endometriosis on the prognosis of OCCC.

The study reviewed the clinicopathologic data of 109 patients with OCCC arising (n = 47) or not arising (n = 62) in endometriosis between 1997 and 2012 at two tertiary medical centers. Tumor response and survival were compared between the two groups. For further evaluation, PubMed, EmBase, and the Cochrane Library were searched, and a meta-analysis was conducted using 10 cohort studies published from March 1996 to May 2014, including the current cohort study.

Complete response did not differ between the patients with OCCC arising in endometriosis and those without endometriosis (77.5 vs. 87.3 %; P = 0.444). Early-stage disease and optimal debulking surgery were the only independent factors that reduced the risk of noncomplete response (adjusted odds ratios 0.203 and 0.038; 95 % confidence intervals [CIs] 0.045–0.920 and 0.006–0.226, respectively). Progression-free survival (PFS) and overall survival (OS) did not differ between the two groups. Early-stage disease and optimal debulking surgery were the only favorable factors that improved PFS (adjusted hazard ratios [HRs] 0.216 and 0.332; 95 % CIs 0.099–0.469 and 0.150–0.732, respectively) and OS (adjusted HRs 0.099 and 0.339; 95 % CIs 0.039–0.252 and 0.141–0.815, respectively). Furthermore, crude and subgroup meta-analyses showed no effect of endometriosis on PFS or OS in OCCC patients.

Endometriosis may not affect the tumor response or the prognosis of OCCC patients. Similar content being viewed by others

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Aust N Z J Obstet Gynaecol. 2014;54:225–30. Acknowledgments This research was supported by grants from the Seoul National University Hospital research fund (Nos. 04-2012-0890 and 03-2012-0170) and the Priority Research Centers Program (No. 2009-0093820), the Basic Science Research Program (No. 2011-0025394), and the BK21 plus program (No. 5256-20140100) through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology. Moreover, it also was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health of Welfare (HI14C2404). Conflict of interest There are no conflicts of interest. Author information Authors and Affiliations Corresponding author Electronic Supplementary Material Below is the link to the electronic supplementary material. 10434_2014_4319_MOESM2_ESM.pptx (download PPTX ) Funnel plots with Egger’s tests representing no publication bias in this meta-analysis for comparing (a) progression-free survival and (b) overall survival between patients who have ovarian clear cell carcinoma (OCCC) with endometriosis and those without endometriosis. (PPTX 70 kb) Rights and permissions About this article Cite this article Kim, H.S., Kim, M.A., Lee, M. et al. Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis. Ann Surg Oncol 22, 2738–2745 (2015). https://doi.org/10.1245/s10434-014-4319-9 Received: Published: Issue date: DOI: https://doi.org/10.1245/s10434-014-4319-9