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Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer
Author(s) -
Matsuo Koji,
Shimada Muneaki,
Yamaguchi Satoshi,
Kanao Hiroyuki,
Nakanishi Toru,
Saito Toshiaki,
Kamiura Shoji,
Iwata Takashi,
Mikami Mikio,
Sugiyama Toru
Publication year - 2017
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31084
Subject(s) - stage (stratigraphy) , cervical cancer , ovarian cancer , gynecology , medicine , oncology , population , cancer , obstetrics , biology , environmental health , paleontology
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.