TY - JOUR
T1 - Clinicopathological characterization of a real-world multicenter cohort of endometrioid ovarian carcinoma
T2 - Analysis of the French national ESME-Unicancer database
AU - De Nonneville, Alexandre
AU - Zemmour, Christophe
AU - Frank, Sophie
AU - Joly, Florence
AU - Ray-Coquard, Isabelle
AU - Costaz, Hèlène
AU - Classe, Jean Marc
AU - Floquet, Anne
AU - De la Motte Rouge, Thibault
AU - Colombo, Pierre Emmanuel
AU - Sauterey, Baptiste
AU - Leblanc, Eric
AU - Pomel, Christophe
AU - Marchal, Frédéric
AU - Barranger, Emmanuel
AU - Savoye, Aude Marie
AU - Guillemet, Cécile
AU - Petit, Thierry
AU - Pautier, Patricia
AU - Rouzier, Roman
AU - Gladieff, Laurence
AU - Simon, Gaëtane
AU - Courtinard, Coralie
AU - Sabatier, Renaud
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - 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.
AB - 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.
KW - Endometrioid
KW - Epidemiology
KW - Ovarian cancer
KW - Prognostic factors
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85110665626&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2021.07.019
DO - 10.1016/j.ygyno.2021.07.019
M3 - Article
C2 - 34294414
AN - SCOPUS:85110665626
SN - 0090-8258
VL - 163
SP - 64
EP - 71
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -