Malignancy History in Patients with Endometriosis: A Retrospective Observational Study Endometriozisli Hastalarda Malignite Spektrumu: Retrospektif Gözlemsel Bir Çalışma

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Güzelbağ B., Pişkin N., Bestel A., Çelik E., GÖKSEVER ÇELİK H.

Turkish Journal of Reproductive Medicine and Surgery, cilt.10, sa.1, ss.18-24, 2026 (Scopus, TRDizin)

Özet

Objective: Endometriosis affects about 10% of reproductive-aged women and has been linked to increased malignancy risk, particularly ovarian cancer. However, data on the broader range of cancers and their clinical features in endometriosis patients remain limited. To evaluate clinical features, treatment characteristics, and malignancy history of endometriosis patients managed at a tertiary gynecology center and to compare the characteristics of patients with and without malignancy. Material and Methods: This retrospective study included 191 patients with histopathologically or ultrasonographically confirmed advanced endometriosis (revised American Society for Reproductive Medicine stage III-IV) treated between 2012 and 2021. Clinical data were obtained from medical records and telephone interviews, while malignancy diagnoses were verified via national health records and pathology reports. Results: Median age was 39 years (range: 21-62), and median CA-125 level was 43 U/mL (range: 5-548). Malignancy was detected in 6 patients (3.1%) at a median age of 41 years (range: 32-50). Most malignancies were non-gynecological (4/6, 66.7%), including papillary thyroid carcinoma (n=2), breast cancer (n=1), and malignant meningioma (n=1). Gynecological cancers (2/6, 33.3%) included ovarian clear cell carcinoma and synchronous endometrial and breast cancer. No significant differences were found between patients with and without malignancy regarding age (p=0.327), CA-125 levels (p=0.706), pain symptoms, hormonal therapy, or prior surgery (all p>0.05). Conclusion: Malignancy was rare (3.1%) but predominantly non-gynecological, contrasting with literature emphasizing ovarian cancer. The lack of distinct predictors highlights the complexity of cancer risk in endometriosis and the need for careful clinical follow-up in this population, though prospective studies with control groups are needed to establish definitive surveillance recommendations.