Hereditary portion as an initial genetic approach in gynecologic cancer: synchronous tumor of ovary and endometrium

To the editor: Hereditary portion and genetic status are very important to work out strategies for cancer prevention and early detection in gynecologic cancers. Familial history of related cancers within the second degree relatives are approximately 10% and 20% in endometrial cancer and ovarian cancer, respectively [1,2]. The proportion of genetic background and germline mutation in Korean women with gynecologic cancer is comparable to those of western ethnics [1,2]. Two interesting articles dealing synchronous cancers of endometrium and ovary appeared in the December issue [3,4]. The 5-year overall survival of women with synchronous cancers of endometrium and ovary was 78% from Singapore [3]. The majority of them were at early stage (83% and 83% for endometrial and ovarian cancer, respectively). The rate of recurrence was 13.6% (6/46). The site of recurrence could be depicted in detail to understand the course of synchronous cancers of endometrium and ovary. Kim et al. [4] reported 32 synchronous tumors of endometrium and ovary treated between 1995 and 2001 of Samsung Medical Center. Of 32 patients, 9 patients (28%) have a family history of cancer. In table 4, lung cancer, pancreatic cancer, or stomach cancer was included. Related to hereditary nonpolyposis colorectal cancer (HNPCC), Amsterdam criteria II or revised criteria of suspected HNPCC was used. The criteria for familial history used in the study should be clearly specified. Therefore, definitive incidence of HNPCC using clinical criteria could be clearly depicted. The proportion of both endometrioid adenocarcinoma in endometrium and ovary were 50% (18/36) and 74% (34/46) from Korea and Singapore, respectively [3,4]. The authors from two studies could reveal the proportion of synchronous tumor from metachronous tumor among both endometriod histology in endometrium and ovary from cancer registry of endometrial cancer and ovarian cancer, respectively. Clarifying the proportion of synchronous tumor of endometrium and ovary is the beginning of the basic research and clinical application of hereditary gynecologic cancer.