General Gynecology Gynecologic Oncology
RRM Academy Synopsis
Endometriosis carries about a 1% cancer risk in premenopausal women
About 1 out of 100 premenopausal women with endometriosis face malignant change, a 2024 review reports. Genes, oxidative stress, hormones, and inflammation are proposed causes of that shift. The review also describes tests and treatments for this cancer, called endometriosis-associated ovarian cancer (EAOC).
Key Findings
- The review gives the risk of malignant transformation in premenopausal women with endometriosis as approximately 1%, and the likelihood in postmenopausal women as 1-2.5%.
- A cohort study cited by the authors found ovarian cancer prevalence 1.37 times higher in women with endometriosis than in the general population.
- Risk of EAOC rises when disease lasts more than 10 years after the first diagnosis, or when ovarian endometriosis recurs often.
- A retrospective case-control study named age, menopause, weight loss, cyst diameter of 8.33cm or more, and solid areas on ultrasound as EAOC risk factors.
- In retrospective studies, a preoperative CA125 blood test was ineffective for spotting malignant change in endometriosis.
Interpretation
The authors wrote a narrative review. They searched PubMed for papers from the last five years and kept only those with complete experimental data. The evidence includes tissue samples, cell lines, mouse models, and retrospective clinical studies. The authors conclude that the mechanisms of carcinogenesis in EAOC remain unclear.
RRM Context
Restorative reproductive medicine seeks the root cause of endometriosis. The review names missing progesterone during steady estrogen exposure as a potential hazard for cancer, and it describes estrogen building up in lesions. Ultrasound can show a solid area with blood vessels in a malignant cyst.
Abstract
Previous studies have shown that the risk of malignant transformation of endometriosis in premenopausal women is approximately 1%, significantly impacting the overall well-being and quality of life of affected women. Presently, the diagnostic gold standard for endometriosis-associated ovarian cancer (EAOC) continues to be invasive laparoscopy followed by histological examination. However, the application of this technique is limited due to its high cost, highlighting the importance of identifying a non-invasive diagnostic approach. Therefore, there is a critical need to explore non-invasive diagnostic methods to improve diagnostic precision and optimize clinical outcomes for patients. This review presents a comprehensive survey of the current progress in comprehending the pathogenesis of malignant transformation in endometriosis. Furthermore, it examines the most recent research discoveries concerning the diagnosis of EAOC and emphasizes potential targets for therapeutic intervention. The ultimate objective is to improve prevention, early detection, precise diagnosis, and treatment approaches, thereby optimizing the clinical outcomes for patients.
Read the guide
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Endometriosis Explained: Diagnosis, Excision Surgery, and the RRM Approach
Endometriosis is a chronic inflammatory disease that drives pain, organ dysfunction, and infertility. How RRM-trained clinicians diagnose and treat it through excision surgery, cycle charting, and longitudinal care.
Topics
Keywords
EAOC, diagnosis, ovarian cancer, pathogenesis, treatment
