title: Improved clinical outcomes of patients with ovarian carcinoma arising in endometriosis.
abstract: BACKGROUND
  Despite enormous efforts to dissect the role of endometriosis in ovarian cancer development, the difference in prognosis between ovarian cancer patients with or without endometriosis remains elusive. The purpose of this study is to assess the association between endometriosis and the prognosis in patients with ovarian cancer.
  
  
  RESULTS
  Ovarian cancer arising in endometriosis tended to be presented as clear cell histology, early stage, less intraperitoneal metastasis and ascites, and lower CA125 level compared with those without endometriosis. Multivariate Cox regression analysis identified endometriosis as an independent prognostic factor for progression free survival (P = 0.002) and overall survival (P = 0.009) in all patients and especially for early stage. A nomogram integrating endometriosis, FIGO stage and CA125 was established to predict progression free survival and overall survival.
  
  
  METHODS
  This study retrospectively enrolled 196 ovarian cancers arising or not in endometriosis judged by adjunctive use of CD10 immunohistochemistry in conjunction with H&E staining specimens. Clinicopathologic variables, progression-free survival (PFS) and overall survival (OS) were recorded. Kaplan-Meier analysis was performed to compare survival curves. Cox regression models were used to analyze the effect of endometriosis on PFS and OS. A prognostic nomogram was constructed based on the independent prognostic factors identified by multivariate analysis.
  
  
  CONCLUSIONS
  Endometriosis is an independent predictor of prognosis in ovarian cancer patients.
authors.affiliation: Department of Gynaecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Tao
authors.affiliation: Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Gynaecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Zehua
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Haiou
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Gynaecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.|Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Congjian
authors.initials: C
authors.lastname: Xu
mesh_terms: D018394:CA-125 Antigen / Q000378:metabolism; D018572:Disease-Free Survival; D004715:Endometriosis / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D008565:Membrane Proteins / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D049451:Nomograms; D010051:Ovarian Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins
keywords: endometriosis; ovarian cancer; overall survival; prognostic marker; progression-free survival