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. 2022 Nov 2;31(11):2038-2045.
doi: 10.1158/1055-9965.EPI-22-0587.

Mortality Patterns of Synchronous Uterine and Ovarian Cancers: A SEER Registry Analysis

Robert Lee Dood  1   2 , Lisa M Pappas  2 , Lindsay J Collin  2   3 , Chelsey Vranes  1 , Britton Trabert  1   2 , Jennifer Anne Doherty  2   3
Affiliations

Mortality Patterns of Synchronous Uterine and Ovarian Cancers: A SEER Registry Analysis

Robert Lee Dood et al. Cancer Epidemiol Biomarkers Prev. .

Abstract

Background: The degree to which uterine cancer metastatic to the ovary is misdiagnosed as synchronous stage I uterine and ovarian cancers is unclear. We sought to determine whether patients with synchronous cancers had mortality patterns similar to either stage IIIA uterine, stage I uterine, or stage I ovarian cancers alone.

Methods: The Surveillance, Epidemiology, and End Results database was used to compare mortality of patients with synchronous stage I uterine and stage I ovarian cancers versus those with stage IIIA uterine, stage I uterine, or stage I ovarian cancers alone. We calculated age-adjusted mortality hazard ratios (HR) and 95% confidence intervals (CI) accounting for calendar year and grade, adjuvant treatment, grade 1 endometrioid cancers, grade 3 endometrioid cancers, and stage IA cancers.

Results: Among the 9,321 patients, we observed lower age-adjusted mortality in patients with stage I synchronous cancers (n = 937) compared to those with stage IIIA uterine (n = 531; HR, 0.45 95% CI, 0.35-0.58), stage I uterine (n = 6,919; HR, 0.74; 95% CI, 0.60-0.91), and stage I ovarian cancers (n = 934; HR, 0.52; 95% CI, 0.41-0.67). Results were similar after taking into account diagnosis year and grade, and limiting to those receiving adjuvant therapy, grade 1 or grade 3 endometrioid cancers, or stage IA cancers.

Conclusions: We observed lower mortality for synchronous stage I uterine and ovarian cancers, which was not explained by younger age, earlier stage, lower grade, histology type, or adjuvant therapy.

Impact: The possible misdiagnosis associated with clinicopathologic of synchronous uterine and ovarian cancers does not appear to worsen survival on a population level.

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Conflict of interest statement

The authors report no conflict of interest

Figures

Figure 1:
Figure 1:
Distribution of histologies for synchronous uterine and ovarian cancers, n=937. The proportions of endometrioid, mixed, serous and other histologies are depicted for uterine cancers in the inner ring, and ovarian cancers in the outer ring, among patients with synchronous primaries.
Figure 2:
Figure 2:
Overall survival by cancer type. This figure depicts unadjusted overall survival for patients with synchronous stage I (SI) uterine and SI ovarian, stage I ovarian, stage I uterine, and stage IIA (SIIIA) cancers, SEER 2004–2015.
Figure 3:
Figure 3:
Age-adjusted mortality HRs for synchronous uterine and ovarian cancers by non-synchronous cancer type, SEER 2004–2015. Hazard ratios (diamonds) and 95% confidence intervals for each pair-wise comparison are depicted, with synchronous uterine and ovarian cancers compared to each of the other cancer types. Analyses include age-adjusted overall survival, diagnosis (DX) year adjusted, grade adjusted, and restricted to those receiving adjuvant therapy, endometrioid histology, grade 1 endometrioid histology, and grade 3 endometrioid histology, and stage IA uterine or ovarian cancers only (for all cancer types except for stage IIIA uterine cancers).
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