Ovarian preservation in adenocarcinoma of the uterine cervix
Abstract Background An upward trending incidence in cervical adenocarcinoma (ADC) has been reported in many countries. Because non-squamous histology has been associated with increased risk of ovarian metastases (OM), bilateral oophorectomy is commonly performed for ADC without due consideration for...
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doaj-5daab68a65244975b5f78cfd180c26e42020-11-24T23:44:14ZengBMCJournal of Ovarian Research1757-22152017-07-011011510.1186/s13048-017-0339-yOvarian preservation in adenocarcinoma of the uterine cervixJiansong Zhou0Yuanyuan Chen1Ping Zhang2Hanmei Lou3The Key Laboratory of Radiation Oncology of Zhejiang Province, Department of Gynecologic Radiation Oncology, Zhejiang Cancer HospitalDepartment of Radiation Oncology, Hangzhou Cancer HospitalDepartment of Gynecologic Oncology, Zhejiang Cancer HospitalThe Key Laboratory of Radiation Oncology of Zhejiang Province, Department of Gynecologic Radiation Oncology, Zhejiang Cancer HospitalAbstract Background An upward trending incidence in cervical adenocarcinoma (ADC) has been reported in many countries. Because non-squamous histology has been associated with increased risk of ovarian metastases (OM), bilateral oophorectomy is commonly performed for ADC without due consideration for ovarian preservation, degrading the quality of life for young premenopausal patients. Methods Subjects were patients with International Federation of Gynecology and Obstetrics (FIGO) stage I–IIB cervical ADC who underwent radical hysterectomy, including pelvic lymphadenectomy and bilateral salpingo-oophorectomy at our institution between Oct. 2006 and Sept. 2014. Clinicopathologic variables were studied by univariate and multivariate analyses. Results Of the 312 patients enrolled in the study, 14 patients (4.5%) developed OM. Multivariate analysis revealed that uterine corpus involvement (odds ratio [OR] 5.178, p = 0.019), parametrial involvement (OR 14.125, p = 0.005) and vaginal infiltration (OR 4.167, p = 0.047) were independently associated with metastasis. OM had no effect on either relapse-free survival (95% confidence interval [CI]: 0.077–4.095, p = 0.57) or overall survival (95% CI: 0.893–9.820, p = 0.076). Conclusion Cervical ADC is associated with an increased risk of OM. Ovarian preservation surgery in cervical ADC may be safe for young patients at an early FIGO stage without deep stromal, endometrial or perineural invasion, and particularly without uterine corpus invasion, parametrial involvement and infiltration into the vagina.http://link.springer.com/article/10.1186/s13048-017-0339-yAdenocarcinomaOvarian metastasisOvarian preservation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiansong Zhou Yuanyuan Chen Ping Zhang Hanmei Lou |
spellingShingle |
Jiansong Zhou Yuanyuan Chen Ping Zhang Hanmei Lou Ovarian preservation in adenocarcinoma of the uterine cervix Journal of Ovarian Research Adenocarcinoma Ovarian metastasis Ovarian preservation |
author_facet |
Jiansong Zhou Yuanyuan Chen Ping Zhang Hanmei Lou |
author_sort |
Jiansong Zhou |
title |
Ovarian preservation in adenocarcinoma of the uterine cervix |
title_short |
Ovarian preservation in adenocarcinoma of the uterine cervix |
title_full |
Ovarian preservation in adenocarcinoma of the uterine cervix |
title_fullStr |
Ovarian preservation in adenocarcinoma of the uterine cervix |
title_full_unstemmed |
Ovarian preservation in adenocarcinoma of the uterine cervix |
title_sort |
ovarian preservation in adenocarcinoma of the uterine cervix |
publisher |
BMC |
series |
Journal of Ovarian Research |
issn |
1757-2215 |
publishDate |
2017-07-01 |
description |
Abstract Background An upward trending incidence in cervical adenocarcinoma (ADC) has been reported in many countries. Because non-squamous histology has been associated with increased risk of ovarian metastases (OM), bilateral oophorectomy is commonly performed for ADC without due consideration for ovarian preservation, degrading the quality of life for young premenopausal patients. Methods Subjects were patients with International Federation of Gynecology and Obstetrics (FIGO) stage I–IIB cervical ADC who underwent radical hysterectomy, including pelvic lymphadenectomy and bilateral salpingo-oophorectomy at our institution between Oct. 2006 and Sept. 2014. Clinicopathologic variables were studied by univariate and multivariate analyses. Results Of the 312 patients enrolled in the study, 14 patients (4.5%) developed OM. Multivariate analysis revealed that uterine corpus involvement (odds ratio [OR] 5.178, p = 0.019), parametrial involvement (OR 14.125, p = 0.005) and vaginal infiltration (OR 4.167, p = 0.047) were independently associated with metastasis. OM had no effect on either relapse-free survival (95% confidence interval [CI]: 0.077–4.095, p = 0.57) or overall survival (95% CI: 0.893–9.820, p = 0.076). Conclusion Cervical ADC is associated with an increased risk of OM. Ovarian preservation surgery in cervical ADC may be safe for young patients at an early FIGO stage without deep stromal, endometrial or perineural invasion, and particularly without uterine corpus invasion, parametrial involvement and infiltration into the vagina. |
topic |
Adenocarcinoma Ovarian metastasis Ovarian preservation |
url |
http://link.springer.com/article/10.1186/s13048-017-0339-y |
work_keys_str_mv |
AT jiansongzhou ovarianpreservationinadenocarcinomaoftheuterinecervix AT yuanyuanchen ovarianpreservationinadenocarcinomaoftheuterinecervix AT pingzhang ovarianpreservationinadenocarcinomaoftheuterinecervix AT hanmeilou ovarianpreservationinadenocarcinomaoftheuterinecervix |
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