Jinekolojik malignite nedeniyle cerrahi uygulanan hastalarda senkron tümörlerin klinikopatolojik profili: retrospektif tek merkezli çalışma

Yıl 2025, Cilt: 6 Sayı: 5, 551 - 556, 24.10.2025

Işık Sözen , Gözde Şahin , Can Berk Karabudak , Aidana Sharip Kyzy , İlayda Aksoy , Yahya Özgün Öner , Başak Özge Kayan , Fatma Benli Tanrıkulu , Tolga Çiftpınar , İlkbal Temel

Öz

Amaç: Bu çalışmanın amacı jinekolojik maligniteler nedeniyle ameliyat edilen kadınlarda senkron tümörlerin türlerini ve klinikopatolojik özelliklerini tanımlamaktı.
Yöntemler: Bu retrospektif tek merkezli çalışmaya patolojik olarak eş zamanlı tümör tanısı almış ardışık 20 hasta dahil edildi. Hastaların demografik verileri, HPV/sitoloji bulguları, cerrahi prosedürler, histopatolojik bulguları, tedavi tipleri ve erken dönem sonuçları (nüks, mortalite) incelendi ve analiz edildi.
Bulgular: Ortalama yaş 60,3 yıl ve ortalama BKİ 31,6 kg/m² idi. Hipertansiyon ve diyabet oranı her biri için %35 idi. Çoğu hastada HPV negatifti (%90); sitoloji %65'inde negatifti (anormallikler: ASC-US %20, ASC-H %5, HSIL %10). Hastaların %80'inde senkron endometrial ve over karsinomu (SEOC) gözlendi. Hastaların çoğunda endometrioid adenokarsinom vardı. SEOC hastaların %62,5'inde evre I-II tümörler vardı ve bu vakalarda tümörler arasındaki histolojik uyum %62,5 evreleme uyumu %75 idi.
Sonuç: SEOC, senkron tümörler arasında yüksek histolojik uyumla ön plana çıkmıştır. SEOC genellikle erken evrede tespit edilse de, hem histoloji hem de evreleme açısından senkron tümörler arasında önemli bir uyum vardı.

Anahtar Kelimeler

senkron tümörler , endometrial kanser , over kanseri , endometrioid adenokarsinom , seröz karsinom

Clinicopathologic profile of synchronous tumors in patients undergoing surgery for gynecologic malignancy: a retrospective single-center study

Öz

Aims: This study aimed to characterize tumor types and clinicopathological features of synchronous tumors in women operated for gynecologic malignancies.
Methods: This retrospective, single-center study included 20 consecutive patients with a pathological diagnosis of synchronous tumors. Patient demographics, HPV/cytology findings, surgical procedures, histopathological features, treatment modalities, and early outcomes (recurrence and mortality) were collected and analyzed.
Results: Mean age was 60.3 years and mean BMI was 31.6 kg/m². Hypertension and diabetes were each present in 35%. Most were HPV-negative (90%); cytology was negative in 65% (abnormalities: ASC-US 20%, ASC-H 5%, HSIL 10%). Synchronous endometrial and ovarian carcinoma (SEOC) was observed in 80% of the patients. The majority of patients had endometrioid adenocarcinoma (EAC). Among SEOC patients, 62.5% had stage I–II tumors. In these cases, histological concordance between synchronous tumors was 62.5%, while staging concordance was 75%.
Conclusion: SEOC predominated with high histologic concordance between synchronous tumors. Although SEOC is typically detected at an early stage, there was significant concordance between synchronous tumors in terms of both histology and staging.

Anahtar Kelimeler

Synchronous tumors , endometrial cancer , ovarian cancer , endometrioid adenocarcinoma , serous carcinoma

Kaynakça

• Hao L, Zhang L, Xu C, Jiang M, Zhu G, Guo J. Multiple synchronous primary malignant neoplasms: a case report and literature review. Oncol Lett. 2023;26(4):428. doi:10.3892/ol.2023.14014
• Ayhan A, Yalcin OT, Tuncer ZS, Gurgan T, Kucukali T. Synchronous primary malignancies of the female genital tract. Eur J Obstet Gynecol Reprod Biol. 1992;45(1):63-66. doi:10.1016/0028-2243(92)90195-5
• Yang EJ, Lee JH, Lee AJ, et al. Multiple primary malignancies in patients with gynecologic cancer. J Clin Med. 2021;11(1):115. doi:10.3390/jcm 11010115
• Narin MA, Karalok A, Basaran D, et al. Coexisting primary cancers of endometrium and ovary: experience of single institution. Int J Hematol Oncol. 2015;35(1):172-177. doi:10.4999/uhod.151002
• Monist M, Lewkowicz D, Pietak P, Pilewska-Kozak A, Man YG, Semczuk A. Synchronously occurring endometrioid carcinomas of the uterine corpus and uterine cervix preceded by different precancerous lesions: a case study and a literature review. Pathol Res Pract. 2023;245:154452. doi:10.1016/j.prp.2023.154452
• Gan W, Bian C. The research progress on synchronous endometrial and ovarian carcinoma. Front Oncol. 2023;13:1291602. doi:10.3389/fonc. 2023.1291602
• Li L, Yao M, Li L, Shi S, Song Y. Synchronous endometrial/cervical and ovarian/fallopian tube carcinoma: a genome-wide mutation analysis. J Pathol Clin Res. 2025;11(5):e70040. doi:10.1002/2056-4538.70040
• Lim YK, Padma R, Foo L, et al. Survival outcome of women with synchronous cancers of endometrium and ovary: a 10 year retrospective cohort study. J Gynecol Oncol. 2011;22(4):239-243. doi:10.3802/jgo.2011. 22.4.239
• Takeda T, Tsuji K, Banno K, et al. Screening for Lynch syndrome using risk assessment criteria in patients with ovarian cancer. J Gynecol Oncol. 2018;29(3):e29. doi:10.3802/jgo.2018.29.e29
• Gungor T, Kanat-Pektas M, Ustunyurt E, Mollamahmutoglu L. Synchronous primary tumors of the female genital tract: a single center experience. Arch Gynecol Obstet. 2009;279(5):667-672. doi:10.1007/s00404-008-0800-7
• AlHilli MM, Dowdy SC, Weaver AL, et al. Incidence and factors associated with synchronous ovarian and endometrial cancer: a population-based case-control study. Gynecol Oncol. 2012;125(1):109-113. doi:10.1016/j.ygyno.2011.12.444
• Herrinton LJ, Voigt LF, Weiss NS, Beresford SA, Wingo PA. Risk factors for synchronous primary endometrial and ovarian cancers. Ann Epidemiol. 2001;11(8):529-533. doi:10.1016/s1047-2797(01)00237-x
• Khoiwal K, Gaurav A, Tiwari S, Chaturvedi J, Singh A. Synchronous primary malignancy of female genital tract: a report of two cases and review of literature. J Midlife Health. 2019;10(1):51-54. doi:10.4103/jmh.JMH_138_18
• Salvo G, Odetto D, Pareja R, Frumovitz M, Ramirez PT. Revised 2018 International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging: a review of gaps and questions that remain. Int J Gynecol Cancer. 2020;30(6):873-878. doi:10.1136/ijgc-2020-001257
• Prat J, Oncology FCoG. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014;124(1):1-5. doi:10.1016/j.ijgo.2013.10.001
• Singh N. Synchronous tumours of the female genital tract. Histopathology. 2010;56(3):277-285. doi:10.1111/j.1365-2559.2009.03367.x
• Soliman PT, Slomovitz BM, Broaddus RR, et al. Synchronous primary cancers of the endometrium and ovary: a single institution review of 84 cases. Gynecol Oncol. 2004;94(2):456-462. doi:10.1016/j.ygyno.2004. 05.006
• Kobayashi Y, Nakamura K, Nomura H, et al. Clinicopathologic analysis with immunohistochemistry for DNA mismatch repair protein expression in synchronous primary endometrial and ovarian cancers. Int J Gynecol Cancer. 2015;25(3):440-446. doi:10.1097/IGC. 0000000000000377
• Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E. Endometrial cancer. Lancet. 2016;387(10023):1094-1108. doi:10.1016/S0140-6736(15) 00130-0
• Jain V, Sekhon R, Pasricha S, et al. Clinicopathological characteristics and prognostic factors of synchronous endometrial and ovarian cancers-a single-institute review of 43 cases. Int J Gynecol Cancer. 2017; 27(5):938-946. doi:10.1097/IGC.0000000000000971
• Zaino R, Whitney C, Brady MF, DeGeest K, Burger RA, Buller RE. Simultaneously detected endometrial and ovarian carcinomas--a prospective clinicopathologic study of 74 cases: a gynecologic oncology group study. Gynecol Oncol. 2001;83(2):355-362. doi:10.1006/gyno.2001. 6400
• Debska-Szmich S, Czernek U, Krakowska M, et al. Synchronous primary ovarian and endometrial cancers: a series of cases and a review of literature. Prz Menopauzalny. 2014;13(1):64-69. doi:10.5114/pm.2014. 41084
• Liu Y, Li J, Jin H, Lu Y, Lu X. Clinicopathological characteristics of patients with synchronous primary endometrial and ovarian cancers: a review of 43 cases. Oncol Lett. 2013;5(1):267-270. doi:10.3892/ol.2012.943
• Calmon MS, Lemos FFB, Silva Luz M, et al. Immune pathway through endometriosis to ovarian cancer. World J Clin Oncol. 2024;15(4):496-522. doi:10.5306/wjco.v15.i4.496
• Zhai J, Vannuccini S, Petraglia F, Giudice LC. Adenomyosis: mechanisms and pathogenesis. Semin Reprod Med. 2020;38(2-03):129-143. doi:10.1055/s-0040-1716687
• Martire FG, Costantini E, D'Abate C, et al. Endometriosis and adenomyosis: from pathogenesis to follow-up. Curr Issues Mol Biol. 2025;47(5):298. doi:10.3390/cimb47050298
• Chiang YC, Chen CA, Huang CY, Hsieh CY, Cheng WF. Synchronous primary cancers of the endometrium and ovary. Int J Gynecol Cancer. 2008;18(1):159-164. doi:10.1111/j.1525-1438.2007.00975.x
• Moro F, Leombroni M, Pasciuto T, et al. Synchronous primary cancers of endometrium and ovary vs endometrial cancer with ovarian metastasis: an observational study. Ultrasound Obstet Gynecol. 2019;53(6):827-835. doi:10.1002/uog.20213
• Song T, Seong SJ, Bae DS, et al. Prognostic factors in women with synchronous endometrial and ovarian cancers. Int J Gynecol Cancer. 2014;24(3):520-527. doi:10.1097/IGC.0000000000000073
• Koç N, Arınkan SA, Şahin D, Temizkan O. Synchronous endometrial and ovarian carcinomas; correlation of clinicopathological parameters with recurrence and survival. Haydarpaşa Numune Med J. 2022;62(4):440. doi:10.14744/hnhj.2021.76476
• Wang M, Li Y, Xu J, Xu S, Wu Y. Prognosis of synchronous endometrial and ovarian cancer based on the PROMISE molecular system. Chin Med J (Engl). 2024;137(15):1870-1872. doi:10.1097/CM9.0000000000003062