1 Enliven Archive | www.enlivenarchive.org 2015 | Volume 2 | Issue 3 Endometriosis Associated Ovarian Cancer, does Direct Transition Matter? * Corresponding author: Dina Reda Bassiouny, MD, Department of Pathology, Sunnybrook Health Sciences Centre, Canada; Tel: 416 480 6100 ext. 3130; E-mail: Dina.Bassiouny@Sunnybrook.ca Citation: Bassiouny DR, El-Baz MA, Gamil TM, Shams N, Ismiil N, et al. (2015) Endometriosis associated ovarian cancer, does direct transition matter? Enliven: Gynecol Obstet 2(3): 006. Copyright: @ 2015 Dr. Dina R. Bassiouny. This is an Open Access article published and distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Received Date: 1 st July 2015 Accepted Date: 30 th July 2015 Published Date: 7 th August 2015 Retrospective Study Enliven: Gynecology and Obstetrics Dina R. Bassiouny 1 , Mahmoud A. El-Baz 1 , Tawakol M. Gamil 1 , Nazem Shams 2 , Nadia Ismiil 3,4 , Valerie Dube 3,4 , Guangming Han 3,4 , Matthew Cesari 3,4 , Fang-I Lu 3,4 , Elzbieta Slodkowska 3,4 , Sherine Salama 3 , Hak Fai Chiu 3 , Magda Naeim 3 , Nim Li 3 , Hadas Moshonov 3 , Sharon Nofech-Mozes 3,4 , Mahmoud Khalifa 3,4 1 Department of Pathology, Mansoura University, Egypt 2 Surgical Oncology Department, Oncology Centre, Mansoura University, Egypt 3 Sunnybrook Health Sciences Centre, Toronto, On, Canada 4 Department of Laboratory Medicine and Pathobiology, University of Toronto, On, Canada ISSN: 2377-5351 Abstract Endometriosis associated ovarian carcinoma (EAOC) is currently receiving attention due to the controversy about its biological behavior. It is not clear whether tumors with demonstrable transition of benign to malignant lining of ovarian endometriosis differ from ovarian carcinomas with associated endometriosis in cases where direct transition is not evident. This study examined the association between the relationship of endometriosis and ovarian cancer and histopathologic characteristics, p53 status and outcome. Methods 140 patients with EAOC with available tissue met the inclusion criteria. Patients were categorized as EAOC type I when direct transition of benign to malignant lining was identiied in ovarian endometriosis and EAOC type II when ovarian endometriosis was present but no direct transition to carcinoma was demonstrated. Age, histologic type, FIGO stage and disease free survival were compared between the groups. P53 status was determined by immunohistochemistry using tissue microarray. Results Seventy one (51.07%) patients had EAOC type I while 69 (49.6%) patients had EAOC type II. There was a signiicant difference in cell type composition between the groups. The most common histologic type in EAOC type I was endometrioid carcinoma (35, 49.3%) followed by clear cell carcinoma (29, 40.8%) and serous carcinoma (7, 9.9%). The most common histologic type in EAOC type II was serous carcinoma (35, 50.7%) followed by endometrioid carcinoma (20, 29%), clear cell carcinoma (9, 13%) and mucinous carcinoma (5, 7.2%), P < 0.001. Of 140 patients with EAOC, 139 tumor tissue specimens were identiied on the TMAs. Mutant p53, either overexpressed or null phenotype, was detected in 16/71 (22.5%) patients with EAOC type I vs. 33/68 (48.5%) patients with type II, P=0.003. However when p53 status was compared in the two groups by tumor histology and grade, there was no signiicant difference between EAOC type and P53 status. EAOC type I cases were more likely to present at a lower stage. DFS was not associated with EAOC type but was signiicantly decreased in cases with mutant p53. Conclusion In this single institution cohort, the outcome of patients with ovarian carcinoma was related to the histological type and stage. However, the type of EAOC was not independently predictive of outcome. Biological differences such as in p53 status, stage at diagnosis and outcome relect the higher proportion of serous and high grade endometrioid carcinoma in EAOC type II. www.enlivenarchive.org