Archives of Gynecology and Obstetrics

, Volume 297, Issue 4, pp 1005–1013 | Cite as

Is the presence of endometriosis associated with a survival benefit in pure ovarian clear cell carcinoma?

  • Hanifi Sahin
  • Mustafa Erkan Sari
  • Zeliha Firat Cuylan
  • Asuman Nihan Haberal
  • Levent Sirvan
  • Gonca Coban
  • Ibrahim Yalcin
  • Tayfun Güngör
  • Husnu Celik
  • Mehmet Mutlu Meydanli
  • Ali Ayhan
Gynecologic Oncology



The purpose of this study was to compare the prognoses of women with pure ovarian clear cell carcinoma (OCCC) arising from endometriosis to those of women with pure OCCC not arising from endometriosis treated in the same manner.


A dual-institutional, retrospective database review was performed to identify patients with pure OCCC who were treated with maximal or optimal cytoreductive surgery (CRS) followed by paclitaxel/carboplatin chemotherapy between January 2006 and December 2016. Patients were divided into two groups according to the detection of cancer arising in endometriosis or not, on the basis of pathological findings. Demographic, clinicopathological, and survival data were collected, and prognosis was compared between the two groups.


Ninety-three women who met the inclusion criteria were included. Of these patients, 48 (51.6%) were diagnosed with OCCC arising in endometriosis, while 45 (48.4%) had no concomitant endometriosis. OCCC arising in endometriosis was found more frequently in younger women and had a higher incidence of early stage disease when compared to OCCC patients without endometriosis. The 5-year overall survival (OS) rate of the patients with OCCC arising in endometriosis was found to be significantly longer than that of women who had OCCC without endometriosis (74.1 vs. 46.4%; p = 0.003). Although univariate analysis revealed the absence of endometriosis (p = 0.003) as a prognostic factor for decreased OS, the extent of CRS was identified as an independent prognostic factor for both recurrence-free survival (hazard ratio (HR) 8.7, 95% confidence interval (CI) 3.15–24.38; p < 0.001) and OS (HR 11.7, 95% CI 3.68–33.71; p < 0.001) on multivariate analysis.


Our results suggest that endometriosis per se does not seem to affect the prognosis of pure OCCC.


Clear cell adenocarcinoma Endometriosis Epithelial ovarian cancer Prognosis 


Author contributions

HS: project development, data collection, data analysis, and manuscript writing. MES: project development, data collection, and data analysis. ZFC: data collection. ANH: data collection, and manuscript editing. LS: data collection and manuscript editing. GC: data collection. IY: data collection. TG: manuscript editing. HC: manuscript editing. MMM: project development, data collection and manuscript writing/editing. AA: manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Hanifi Sahin
    • 1
  • Mustafa Erkan Sari
    • 1
  • Zeliha Firat Cuylan
    • 1
  • Asuman Nihan Haberal
    • 2
  • Levent Sirvan
    • 3
  • Gonca Coban
    • 4
  • Ibrahim Yalcin
    • 1
  • Tayfun Güngör
    • 1
  • Husnu Celik
    • 4
  • Mehmet Mutlu Meydanli
    • 1
  • Ali Ayhan
    • 4
  1. 1.Department of Gynecologic Oncology, Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of MedicineUniversity of Health SciencesAnkaraTurkey
  2. 2.Department of Pathology, School of MedicineBaskent UniversityAnkaraTurkey
  3. 3.Department of Pathology, Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of MedicineUniversity of Health SciencesAnkaraTurkey
  4. 4.Department of Gynecologic Oncology, School of MedicineBaskent UniversityAnkaraTurkey

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