title: Synchronous primary ovarian and endometrial cancers: a population-based assessment of survival.
abstract: OBJECTIVE
  To estimate the occurrence of synchronous epithelial ovarian and endometrial cancers among ovarian cancer patients and to assess survival of women with synchronous cancers.
  
  
  METHODS
  Synchronous ovarian and endometrial cases were identified using data from the Surveillance, Epidemiology, and End Results Program from 1973 to 2005. Multivariable Cox-proportional hazards regression was used to estimate risk of death from ovarian cancer, comparing synchronous ovarian and endometrial cancers with single ovarian cancers and adjusting for demographic, prognostic, and treatment characteristics.
  
  
  RESULTS
  Synchronous cancers represented less than 3% of the 56,986 epithelial ovarian cancer cases, regardless of the time interval between detection of both cancers. Favorable characteristics for synchronous patients included younger age at diagnosis, earlier stage of disease, and better grade of disease. Multivariable adjusted hazard ratios showed a 25% reduction in risk of death from ovarian cancer for synchronous tumors compared with single tumors (hazard ratio 0.75, 95% confidence interval [CI] 0.66-0.85). In stratified analysis by stage, the corresponding hazard ratios for localized and distant stages were 0.63 (95% CI 0.42-0.95) and 0.70 (95% CI 0.60-0.81), respectively.
  
  
  CONCLUSIONS
  Women with synchronous ovarian and endometrial cancers exhibit favorable survival outcomes as compared with patients with single ovarian cancers, even after adjusting for demographic, prognostic (including stage), and treatment characteristics. The survival advantage associated with having synchronous cancers persisted after analyses were restricted to distant stage.
  
  
  METHODS
  III.
authors.affiliation: From the Robert Wood Johnson Medical School, Division of Surgical Oncology, New Brunswick, NJ; The Cancer Institute of New Jersey, Population Science Program, New Brunswick, NJ; UMDNJ-School of Public Health, Department of Epidemiology, Piscataway, NJ; The Cancer Institute of New Jersey, Robert Wood Johnson Medical School and Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New Brunswick, NJ.
authors.forename: Melony G
authors.initials: MG
authors.lastname: Williams
authors.forename: Elisa V
authors.initials: EV
authors.lastname: Bandera
authors.forename: Kitaw
authors.initials: K
authors.lastname: Demissie
authors.forename: Lorna
authors.initials: L
authors.lastname: Rodríguez-Rodríguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003131:Combined Modality Therapy; D015897:Comorbidity; D003710:Demography; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011159:Population Surveillance; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult