{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:53:20Z","timestamp":1787500400283,"version":"build-2736575974"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Ovarian Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complex epithelial neoplasms of the ovary (CENO), an uncommon pathological histotype in ovarian cancer, comprises adenosquamous carcinoma and adenocarcinoma with metaplasia. Owing to the rarity of relevant reports, there are currently no statistics on outcomes based on large samples. Meanwhile high-grade serous ovarian cancer (HGSOC) is the most common histotype in ovarian cancer which has a recognized first-line treatment regimen and poor prognosis. Thus, we aimed to determine the characteristics, prognosis, and independent predictors of survival for CENO, compare them with those of HGSOC and construct prognostic predictive models and nomograms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the Surveillance, Epidemiology, and End Results (SEER) database to determine patients diagnosed with CENO or HGSOC from 2000 to 2017. Clinical, demographic, and treatment characteristics were compared between these groups. Propensity score matching, Cox risk regression analysis, Kaplan\u2013Meier survival curves, and the Least Absolute Shrinkage and Selection Operator regression analysis were employed for analyzing the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Here, 31,567 patients with HGSOC and 216 patients with CENO between 2000 and 2017 in the SEER database were enrolled. Age\u2009&lt;\u200957\u2009years, unmarried, and early-stage diseases were more common in patients with CENO than in those with HGSOC. Women with CENO were less likely to receive adjuvant chemotherapy (65.7% vs. 79.4%) but more likely to receive radiotherapy (6.0% vs. 0.8%; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than those with HGSOC. Year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors for overall and cancer-specific survival in CENO. Overall survival rates were significantly lower for CENO than for more malignant HGSOC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In summary, CENO was rare in ovarian cancer, while the year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors. Compared with other common malignant ovarian tumors, CENO had a poor prognosis. Prognostic predictive models and nomograms had been determined to predict the individual survival rates of patients with CENO. These methods could improve evaluations of survival and therapeutic decisions for patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13048-022-01063-4","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:19:54Z","timestamp":1669900794000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study"],"prefix":"10.1186","volume":"15","author":[{"given":"Xiaoxue","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiling","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"issue":"3","key":"1063_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209\u201349.","journal-title":"CA Cancer J Clin"},{"issue":"4","key":"1063_CR2","doi-asserted-by":"publisher","first-page":"284","DOI":"10.3322\/caac.21456","volume":"68","author":"LA Torre","year":"2018","unstructured":"Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68(4):284\u201396.","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"1063_CR3","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.path.2021.05.006","volume":"14","author":"Z Ordulu","year":"2021","unstructured":"Ordulu Z, Watkins J, Ritterhouse LL. Molecular Pathology of Ovarian Epithelial Neoplasms: Predictive, Prognostic, and Emerging Biomarkers. Surg Pathol Clin. 2021;14(3):415\u201328.","journal-title":"Surg Pathol Clin"},{"issue":"4","key":"1063_CR4","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1007\/s00404-016-4035-8","volume":"293","author":"I Meinhold-Heerlein","year":"2016","unstructured":"Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P, et al. The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications. Arch Gynecol Obstet. 2016;293(4):695\u2013700.","journal-title":"Arch Gynecol Obstet"},{"key":"1063_CR5","doi-asserted-by":"crossref","unstructured":"Lisio MA, Fu L, Goyeneche A, Gao ZH, Telleria C. High-Grade Serous Ovarian Cancer: Basic Sciences, Clinical and Therapeutic Standpoints. Int J Mol Sci. 2019;20(4).","DOI":"10.3390\/ijms20040952"},{"issue":"6","key":"1063_CR6","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/j.hoc.2018.07.007","volume":"32","author":"AE Freimund","year":"2018","unstructured":"Freimund AE, Beach JA, Christie EL, Bowtell DDL. Mechanisms of Drug Resistance in High-Grade Serous Ovarian Cancer. Hematol Oncol Clin North Am. 2018;32(6):983\u201396.","journal-title":"Hematol Oncol Clin North Am"},{"issue":"5","key":"1063_CR7","first-page":"887","volume":"9","author":"X Li","year":"2019","unstructured":"Li X, Zhang Y, Chai X, Zhou S, Zhang H, He J, et al. Overexpression of MEF2D contributes to oncogenic malignancy and chemotherapeutic resistance in ovarian carcinoma. Am J Cancer Res. 2019;9(5):887\u2013905.","journal-title":"Am J Cancer Res"},{"key":"1063_CR8","volume-title":"International classification of diseases for oncology","author":"A Fritz","year":"2000","unstructured":"Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, et al. International classification of diseases for oncology: Third Edition; 2000."},{"key":"1063_CR9","unstructured":"ICD-0-3 SEER SITE\/HISTOLOGY VALIDATION LIST.\u00a0https:\/\/seer.cancer.gov\/icd-o-3\/sitetype.icdo3.20220429.pdf#search=icd-03%20seer%20site\/histology%20validation%20list"},{"key":"1063_CR10","unstructured":"SEER RESEARCH PLUS DATA DESCRIPTION CASES DIAGNOSED IN 1975\u20132019.\u00a0https:\/\/seer.cancer.gov\/data-software\/documentation\/seerstat\/nov2021\/TextData.FileDescription-nov2021.pdf#search=complex%20epithelial%20neoplasms"},{"issue":"4","key":"1063_CR11","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1053\/j.semdp.2014.06.004","volume":"31","author":"N Rao","year":"2014","unstructured":"Rao N. Adenosquamous carcinoma. Semin Diagn Pathol. 2014;31(4):271\u20137.","journal-title":"Semin Diagn Pathol"},{"issue":"1","key":"1063_CR12","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s13048-016-0255-6","volume":"9","author":"T Shoji","year":"2016","unstructured":"Shoji T, Takatori E, Murakami K, Kaido Y, Takeuchi S, Kikuchi A, et al. A case of ovarian adenosquamous carcinoma arising from endometrioid adenocarcinoma: a case report and systematic review. J Ovarian Res. 2016;9(1):48.","journal-title":"J Ovarian Res"},{"issue":"Suppl 1","key":"1063_CR13","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1136\/ijgc-00009577-200602001-00069","volume":"16","author":"A Karateke","year":"2006","unstructured":"Karateke A, Gurbuz A, Kir G, Haliloglu B, Kabaca C, Devranoglu B, et al. Mucoepidermoid variant of adenosquamous carcinoma arising in ovarian dermoid cyst: a case report and review of the literature. Int J Gynecol Cancer. 2006;16(Suppl 1):379\u201384.","journal-title":"Int J Gynecol Cancer"},{"issue":"3","key":"1063_CR14","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1111\/j.1447-0756.1994.tb00463.x","volume":"20","author":"Y Iwaoki","year":"1994","unstructured":"Iwaoki Y, Katsube Y, Toyota N. Adenosquamous carcinoma arising in a mature cystic teratoma of the ovary: a case report and review of the literature. Asia Oceania J Obstet Gynaecol. 1994;20(3):237\u201343.","journal-title":"Asia Oceania J Obstet Gynaecol"},{"key":"1063_CR15","doi-asserted-by":"publisher","first-page":"6661","DOI":"10.4076\/1757-1626-2-6661","volume":"2","author":"T Terada","year":"2009","unstructured":"Terada T. Adenosquamous carcinoma of the ovary arising from endometriosis: two case reports. Cases J. 2009;2:6661.","journal-title":"Cases J"},{"issue":"1","key":"1063_CR16","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.path.2020.10.002","volume":"14","author":"M Nakaguro","year":"2021","unstructured":"Nakaguro M, Nagao T. Epithelial-Myoepithelial Carcinoma. Surg Pathol Clin. 2021;14(1):97\u2013109.","journal-title":"Surg Pathol Clin"},{"issue":"5","key":"1063_CR17","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1097\/PGP.0b013e31826f0327","volume":"32","author":"DE Roberts","year":"2013","unstructured":"Roberts DE, Lombard CM. Serous carcinoma of the ovary with squamous differentiation: a case report and a literature review. Int J Gynecol Pathol. 2013;32(5):459\u201363.","journal-title":"Int J Gynecol Pathol"},{"issue":"1","key":"1063_CR18","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s12905-021-01336-y","volume":"21","author":"Y Sun","year":"2021","unstructured":"Sun Y, Chen Y, Zhang X, Chen H, Zhou F. Primary ovarian serous carcinomas with extensive squamous differentiation: a case report and literature review. BMC Womens Health. 2021;21(1):193.","journal-title":"BMC Womens Health"},{"issue":"5","key":"1063_CR19","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1007\/s11605-014-2480-x","volume":"18","author":"YJ Zeng","year":"2014","unstructured":"Zeng YJ, Lai W, Liu L, Wu H, Luo XX, Wang J, et al. Prognostic significance of neuroendocrine differentiation in colorectal adenocarcinoma after radical operation: a meta-analysis. J Gastrointest Surg. 2014;18(5):968\u201376.","journal-title":"J Gastrointest Surg"},{"issue":"12","key":"1063_CR20","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.5858\/arpa.2019-0396-RA","volume":"143","author":"ER McMullen","year":"2019","unstructured":"McMullen ER, Zoumberos NA, Kleer CG. Metaplastic Breast Carcinoma: Update on Histopathology and Molecular Alterations. Arch Pathol Lab Med. 2019;143(12):1492\u20136.","journal-title":"Arch Pathol Lab Med"},{"issue":"3","key":"1063_CR21","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/01.PGP.0000055173.04957.66","volume":"22","author":"N Tochigi","year":"2003","unstructured":"Tochigi N, Kishimoto T, Supriatna Y, Nagai Y, Nikaido T, Ishikura H. Hepatoid carcinoma of the ovary: a report of three cases admixed with a common surface epithelial carcinoma. Int J Gynecol Pathol. 2003;22(3):266\u201371.","journal-title":"Int J Gynecol Pathol"},{"issue":"2","key":"1063_CR22","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.path.2019.01.007","volume":"12","author":"L Casey","year":"2019","unstructured":"Casey L, Singh N. Ovarian High-Grade Serous Carcinoma: Assessing Pathology for Site of Origin, Staging and Post-neoadjuvant Chemotherapy Changes. Surg Pathol Clin. 2019;12(2):515\u201328.","journal-title":"Surg Pathol Clin"},{"key":"1063_CR23","doi-asserted-by":"publisher","first-page":"763958","DOI":"10.3389\/fmolb.2021.763958","volume":"8","author":"X Li","year":"2021","unstructured":"Li X, Zeng S, Ding Y, Nie Y, Yang M. Comprehensive Analysis of the Potential Immune-Related Biomarker Transporter Associated With Antigen Processing 1 That Inhibits Metastasis and Invasion of Ovarian Cancer Cells. Front Mol Biosci. 2021;8:763958.","journal-title":"Front Mol Biosci"},{"key":"1063_CR24","doi-asserted-by":"publisher","first-page":"774400","DOI":"10.3389\/fgene.2021.774400","volume":"12","author":"XX Li","year":"2021","unstructured":"Li XX, Xiong L, Wen Y, Zhang ZJ. Comprehensive Analysis of the Tumor Microenvironment and Ferroptosis-Related Genes Predict Prognosis with Ovarian Cancer. Front Genet. 2021;12:774400.","journal-title":"Front Genet"},{"issue":"7","key":"1063_CR25","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1080\/01443615.2020.1835844","volume":"41","author":"A Asali","year":"2021","unstructured":"Asali A, Haj-Yehia N, Zehavi T, Perry T, Beiner M, Fishman A, et al. High grade, advanced, serous ovarian cancer with low serum CA125 levels. J Obstet Gynaecol. 2021;41(7):1107\u201311.","journal-title":"J Obstet Gynaecol"},{"key":"1063_CR26","doi-asserted-by":"publisher","first-page":"3705","DOI":"10.2147\/OTT.S162985","volume":"11","author":"A Li","year":"2018","unstructured":"Li A, Sun S, Song T, Li X, Cheng W, Yao R, et al. Targeted therapy and immunotherapy for platinum-refractory advanced ovarian adenosquamous carcinoma: a case report. Onco Targets Ther. 2018;11:3705\u201311.","journal-title":"Onco Targets Ther"},{"issue":"7","key":"1063_CR27","doi-asserted-by":"publisher","first-page":"883","DOI":"10.5858\/arpa.2017-0485-RS","volume":"143","author":"AM Acosta","year":"2019","unstructured":"Acosta AM, Pins MR. Hepatoid Carcinoma of the Ovary: Clinical, Histopathologic, and Immunophenotypic Features. Arch Pathol Lab Med. 2019;143(7):883\u20139.","journal-title":"Arch Pathol Lab Med"}],"container-title":["Journal of Ovarian Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13048-022-01063-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13048-022-01063-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13048-022-01063-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:22:08Z","timestamp":1669900928000},"score":1,"resource":{"primary":{"URL":"https:\/\/ovarianresearch.biomedcentral.com\/articles\/10.1186\/s13048-022-01063-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,1]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1063"],"URL":"https:\/\/doi.org\/10.1186\/s13048-022-01063-4","relation":{},"ISSN":["1757-2215"],"issn-type":[{"value":"1757-2215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,1]]},"assertion":[{"value":"28 September 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"125"}}