Review

Clinical characteristics and current therapeutic approach of patients with synchronous primary endometrial and ovarian cancers

Androutsopoulos Georgios1, Vitsas Charalampos1, Thanatsis Nikolaos1, Michail Georgios1, Terzakis Emmanouel2, Decavalas Georgios1

1Department of Obstetrics and Gynecology, University of Patras, Medical School, Rio, Patras, Greece
2Department of Gynecology, St. Savvas hospital, Athens, Greece

Correspondence: Androutsopoulos Georgios, Department of Obstetrics and Gynecology, University of Patras, Medical School, Rio, GR-26504, Greece. 21 Nikolaou Apostoli St, GR – 26332, Patras, Greece, E – mail: androutsopoulosgeorgios@hotmail.com


Abstract

Synchronous primary endometrial and ovarian cancers are relatively uncommon in general population. Although their pathogenesis still remains unclear, embryologic, hormonal, genetic or other phenomena may be responsible for the development of synchronous primary endometrial and ovarian cancers. The most common symptoms and signs in those patients are: abnormal uterine bleeding, abdominal/pelvic pain and abdominal/pelvic mass. For most patients with synchronous primary endometrial and ovarian cancers, systematic surgical staging is the baseline therapy and includes total abdominal hysterectomy with bilateral salpingo – oophorectomy, total omentectomy, appendectomy, pelvic and para – aortic lymphadenectomy, complete resection of all disease, biopsy of any suspected lesion and pelvic washings. Moreover, that therapeutic approach allows a more clear decision for stage related postoperative adjuvant therapy. The role of postoperative adjuvant treatment in patients with synchronous primary endometrial and ovarian cancers, remains controversial. In most cases, postoperative adjuvant treatment should be individualized according to the risk of recurrence of each primary cancer. Particularly in patients with increased risk for recurrence or at advanced stage disease, postoperative adjuvant treatment customized to both cancers is required. Patients with synchronous primary endometrial and ovarian cancers have better overall survival than patients with single primary ovarian or endometrial cancer. Perhaps, favorable prognosis is associated with the detection of patients at early stage and low grade disease. Moreover, the clinical efficacy of the postoperative adjuvant treatment should be further investigated.

Keywords: synchronous primary cancers, clinical characteristics, treatment

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