Outcomes and prognostic factors in patients with synchronous endometrial and ovarian cancer

To analyze prognostic factors and survival outcomes in patients with synchronous endometrial and ovarian cancer (SEOC) to guide clinical management. We conducted a retrospective cohort study of patients diagnosed with SEOC at Peking University People's Hospital between January 2004 and December 2024. Clinicopathological data were collected, and oncological outcomes, including progression-free survival (PFS) and overall survival (OS), were analyzed along with their associated prognostic factors. Among 64 included patients, vaginal bleeding was the predominant presenting symptom. Thirty-six patients were diagnosed with concordant endometrioid carcinoma, which was the most common histological type. All patients underwent surgical treatment, among whom 56 received platinum-based chemotherapy postoperatively, with a platinum sensitivity rate of 67.9%. The median PFS and OS were 27 months (range 3–215) and 41 months (range 7–246), respectively. On multivariate analysis, advanced FIGO stage of ovarian cancer (HR = 2.764; 95% CI 1.169–6.536, P = 0.021) independently predicted worse PFS, while platinum resistance (HR = 6.962; 95% CI 2.052–23.619, P = 0.002) was significantly associated with reduced OS. In this cohort, platinum sensitivity was observed in 67.9% of cases. The advanced ovarian FIGO stage and platinum resistance independently correlated with inferior survival, underscoring the urgent need for tailored therapeutic strategies and intensified surveillance in platinum-resistant SEOC.