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Synchronous/metachronous endometrial and colorectal malignancies in Taiwanese women: a population-based nationwide study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Endometrial cancer (EC) and colorectal cancer (CRC) may share a common genetic background. In a subset of patients, the two malignancies can coexist either at the time of diagnosis (synchronous) or develop consequently (metachronous). The purpose of this nationwide, population-based study was to investigate the occurrence and clinical outcomes of synchronous/metachronous EC/CRC in Taiwanese women.

Materials and methods

Data for women diagnosed with EC and/or CRC between 2007 and 2015 were retrospectively retrieved from the nationwide Taiwan Cancer Registry. Mortality data were obtained from the National Death Registry. Women with synchronous/metachronous EC/CRC versus EC or CRC were compared in terms of clinical characteristics and outcomes.

Results

Of the 62,764 Taiwanese women diagnosed with EC and/or CRC during the study period, 167 (0.3%) had synchronous/metachronous EC/CRC. Among them, 72 cases (43.1%) presented with EC followed by CRC, 66 (39.5%) with CRC followed by EC, and 29 (17.4%) with synchronous EC/CRC. Kaplan–Meier estimates for time-to-event data revealed that the 2-year risk rates of developing a metachronous tumor of interest (CRC or EC) in women diagnosed with an initial EC and CRC were 39.6% and 42.1%, respectively. The 5-year overall survival rates of women with metachronous EC/CRC who had an initial diagnosis of EC, CRC, and synchronous EC/CRC were 73.9%, 70.9%, and 37.0%, respectively.

Conclusions

Endometrial cancer is the most common first tumor in Taiwanese women with metachronous EC/CRC. The 2-year risk rates of developing a metachronous tumor of interest (CRC or EC) in women diagnosed with an initial EC and CRC are not negligible. Surveillance for CRC is recommended for all women diagnosed with EC. The clinical outcomes of synchronous EC/CRC are markedly less favorable.

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Abbreviations

CRC:

Colorectal cancer

EC:

Endometrial cancer

MMR:

Mismatch repair

LC:

Lynch syndrome

NDR:

National Death Registry

TCR:

Taiwan Cancer Registry

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Acknowledgements

This study was financially supported by the Chang Gung Memorial Foundation (Grants CMRPG3J0411/2, 3J0401/02, 3J0381/0382, 3J0391/0392, and CIRPG 3K0031). The authors are grateful to Chu-Chun Huang and Jung-Erh Yang for their excellent technical assistance, and statistical assistance provided by the Clinical Trial Center, Chang Gung Memorial Hospital, Linkou, which was founded by the Ministry of Health and Welfare of Taiwan (MOHW110-TDU-B-212-124005).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, College of Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Angel Chao, An-Shine Chao & Chyong-Huey Lai

  2. Gynecologic Cancer Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Angel Chao, Ren-Chin Wu & Chyong-Huey Lai

  3. Department of Pathology, College of Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Ren-Chin Wu

  4. New Taipei Municipal Tu Cheng Hospital, New Taipei City, Taiwan

    An-Shine Chao

  5. Biostatistics Unit, Clinical Trial Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Wei-Yang Chang & Lan-Yan Yang

  6. Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan

    Chen-Hsuan Wu

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  1. Angel Chao
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Contributions

AC and LYY: study concept and design. AC, RCW, and ASC: literature review; WYC and LYY: data analysis. AC, RCW, CHW, and LYY: manuscript writing. AC and CHL: critical revision of the manuscript for important intellectual content. All authors approved the final version.

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Correspondence to Lan-Yan Yang.

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The authors declare no conflicts of interest.

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Ethics approval was received from the Institutional Review Board of the Chang Gung Medical Foundation (Approval No: 201801202B0C502).

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Chao, A., Wu, RC., Chao, AS. et al. Synchronous/metachronous endometrial and colorectal malignancies in Taiwanese women: a population-based nationwide study. Arch Gynecol Obstet 306, 165–172 (2022). https://doi.org/10.1007/s00404-021-06296-0

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  • DOI: https://doi.org/10.1007/s00404-021-06296-0

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