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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2015

01-08-2015 | Gynecologic Oncology

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

Authors: Hee Seung Kim, MD, Min A. Kim, MD, PhD, Maria Lee, MD, Dong Hoon Suh, MD, Kidong Kim, MD, PhD, Jae Hong No, MD, PhD, Hyun Hoon Chung, MD, PhD, Yong Beom Kim, MD, PhD, Yong Sang Song, MD, PhD

Published in: Annals of Surgical Oncology | Issue 8/2015

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Abstract

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.

Methods

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.

Results

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.

Conclusion

Endometriosis may not affect the tumor response or the prognosis of OCCC patients.
Appendix
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Metadata
Title
Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis
Authors
Hee Seung Kim, MD
Min A. Kim, MD, PhD
Maria Lee, MD
Dong Hoon Suh, MD
Kidong Kim, MD, PhD
Jae Hong No, MD, PhD
Hyun Hoon Chung, MD, PhD
Yong Beom Kim, MD, PhD
Yong Sang Song, MD, PhD
Publication date
01-08-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 8/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4319-9

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