Abstract
e17592 Background: Malignant endometrioid adenofibroma (MEA) is a rare subtype of ovarian carcinoma characterized by squamous metaplasia and frequently linked with endometriosis and colorectal cancer. This fibrous tumor with cystic spaces is primarily diagnosed in postmenopausal females who present with abnormal vaginal bleeding. The current recommended treatment option is a laparoscopic resection; however, a hysterectomy may be indicated in more serious cases. Analyzing the trends of MEA may provide significant insights into its epidemiology. An analysis of the National Cancer Database (NCDB) was conducted to identify the demographic factors of patients diagnosed with MEA. Methods: A retrospective cohort analysis utilizing the 2004–2020 National Cancer Database (NCDB) included 193 patients with a histologically-confirmed diagnosis of CA (ICD-O-3 code 8381). Demographic factors (age, sex, race, Hispanic status, insurance status, facility type, distance from facility, and Charlson-Deyo score) were analyzed by descriptive statistics and incidence trends were interpreted in regression analysis. Results: 193 patients diagnosed with MEA were recorded in the database from 2004 to 2019, with a strong declining annual incidence rate (R²=0.7833). Women were much more likely to be diagnosed (99.5%) than men (0.5%), where the average age at diagnosis was 61.40 years (SD= 12.89, Range =30-90). The primary site of diagnosis was the endometrium (54%). Most patients were noted to be non-Hispanic (85%) and White (86%), privately insured (59%), and lived in metropolitan areas with a population greater than 1 million (54%). The majority also had a Charlson-Deyo comorbidity score of 0 (78%). In regard to treatment, patients were seen relatively equally at the comprehensive community cancer program (42%) and academic/research program (32%). 93% of patients received surgery as their primary treatment, 20% received chemotherapy, and 20% received radiation. Conclusions: To the best of our knowledge, this is the first NCDB analysis on malignant endometrioid adenofibroma and thus serves to address prior gaps in the topic’s research. Results were similar to descriptions in earlier case reports, where MEA is notably more common in females who identify as non-Hispanic and White, with a primary site diagnosis at the endometrium. This is the first time the socioeconomic factors of MEA patients have been described in the literature: patients are more likely to live in metropolitan areas, be privately insured, and be treated at similar rates at both academic/research and comprehensive community cancer programs. Further studies are essential in promoting the knowledge of this topic, specifically how demographic/socioeconomic factors influence the diagnosis and treatment options of patients with MEA.