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Multicenter Study
. 2021 Oct;163(1):64-71.
doi: 10.1016/j.ygyno.2021.07.019. Epub 2021 Jul 19.

Clinicopathological characterization of a real-world multicenter cohort of endometrioid ovarian carcinoma: Analysis of the French national ESME-Unicancer database

Alexandre De Nonneville  1 , Christophe Zemmour  2 , Sophie Frank  3 , Florence Joly  4 , Isabelle Ray-Coquard  5 , Hèlène Costaz  6 , Jean-Marc Classe  7 , Anne Floquet  8 , Thibault De la Motte Rouge  9 , Pierre-Emmanuel Colombo  10 , Baptiste Sauterey  11 , Eric Leblanc  12 , Christophe Pomel  13 , Frédéric Marchal  14 , Emmanuel Barranger  15 , Aude-Marie Savoye  16 , Cécile Guillemet  17 , Thierry Petit  18 , Patricia Pautier  19 , Roman Rouzier  20 , Laurence Gladieff  21 , Gaëtane Simon  22 , Coralie Courtinard  23 , Renaud Sabatier  24
Affiliations
Multicenter Study

Clinicopathological characterization of a real-world multicenter cohort of endometrioid ovarian carcinoma: Analysis of the French national ESME-Unicancer database

Alexandre De Nonneville et al. Gynecol Oncol. 2021 Oct.

Abstract

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.

Keywords: Endometrioid; Epidemiology; Ovarian cancer; Prognostic factors; Survival.

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Conflict of interest statement

Declaration of Competing Interest All the authors declare that they have no conflicts of interest to disclose related to this work.

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