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Identifying a candidate population for ovarian conservation in young women with clinical stage IB-IIB cervical cancer.
- Source :
-
International journal of cancer [Int J Cancer] 2018 Mar 01; Vol. 142 (5), pp. 1022-1032. Date of Electronic Publication: 2017 Oct 16. - Publication Year :
- 2018
-
Abstract
- This study seeks to identify risk factors associated with ovarian metastasis and to characterize a population with minimum risk of ovarian metastasis in young women with stage IB-IIB cervical cancer. This was a nation-wide multicenter retrospective study in Japan examining consecutive cases of surgically-treated women with clinical stage IB-IIB cervical cancer who had oophorectomy at radical hysterectomy (n = 5,697). Multivariable analysis was performed to identify independent risk factors for ovarian metastasis. Ovarian metastasis was seen in 70 (1.2%, 95% confidence interval 0.9-1.5) cases. In the entire cohort, adenocarcinoma, lympho-vascular space invasion, uterine corpus tumor invasion, and pelvic/para-aortic nodal metastases remained independent risk factors for ovarian metastasis (all, adjusted-p < 0.05). In a sensitivity analysis of 3,165 women aged <50 years (ovarian metastasis, 1.0%), adenocarcinoma, parametrial tumor involvement, uterine corpus tumor involvement, and pelvic/para-aortic nodal metastases remained independent risk factors for ovarian metastasis (all, adjusted-P < 0.05). In the absence of these five risk factors (representing 46.1% of women aged <50 years), the incidence of ovarian metastasis was 0.14%. With the presence of adenocarcinoma alone (representing 18.9% of women aged <50 years), the incidence of ovarian metastasis was 0.17% and was not associated with increased risk of ovarian metastasis compared to the subgroup without any risk factors (p = 0.87). In conclusion, nearly two thirds of women aged <50 years with clinical stage IB-IIB cervical cancer had no risk factor for ovarian metastasis or had adenocarcinoma alone: these subgroups had ovarian metastasis rates of around 0.1% and may be a candidate population for ovarian conservation at surgical treatment.<br /> (© 2017 UICC.)
- Subjects :
- Adenocarcinoma epidemiology
Adenocarcinoma surgery
Adult
Carcinoma, Squamous Cell epidemiology
Carcinoma, Squamous Cell surgery
Female
Follow-Up Studies
Humans
Japan epidemiology
Lymph Node Excision
Lymphatic Metastasis
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Ovarian Neoplasms epidemiology
Ovarian Neoplasms surgery
Ovariectomy
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Adenocarcinoma secondary
Carcinoma, Squamous Cell secondary
Organ Sparing Treatments methods
Ovarian Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0215
- Volume :
- 142
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 28975603
- Full Text :
- https://doi.org/10.1002/ijc.31084