Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer

Koji Matsuo, Muneaki Shimada, Satoshi Yamaguchi, Hiroyuki Kanao, Toru Nakanishi, Toshiaki Saito, Shoji Kamiura, Takashi Iwata, Mikio Mikami, Toru Sugiyama

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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.

Original languageEnglish
Pages (from-to)1022-1032
Number of pages11
JournalInternational Journal of Cancer
Volume142
Issue number5
DOIs
Publication statusPublished - 2018 Mar 1

Fingerprint

Uterine Cervical Neoplasms
Neoplasm Metastasis
Population
Adenocarcinoma
Neoplasms
Incidence
Ovariectomy
Hysterectomy
Multicenter Studies
Blood Vessels
Japan
Retrospective Studies
Confidence Intervals

Keywords

  • cervical cancer
  • early stage
  • ovarian metastasis
  • radical hysterectomy
  • risk factor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Matsuo, K., Shimada, M., Yamaguchi, S., Kanao, H., Nakanishi, T., Saito, T., ... Sugiyama, T. (2018). Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer. International Journal of Cancer, 142(5), 1022-1032. https://doi.org/10.1002/ijc.31084

Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer. / Matsuo, Koji; Shimada, Muneaki; Yamaguchi, Satoshi; Kanao, Hiroyuki; Nakanishi, Toru; Saito, Toshiaki; Kamiura, Shoji; Iwata, Takashi; Mikami, Mikio; Sugiyama, Toru.

In: International Journal of Cancer, Vol. 142, No. 5, 01.03.2018, p. 1022-1032.

Research output: Contribution to journalArticle

Matsuo, K, Shimada, M, Yamaguchi, S, Kanao, H, Nakanishi, T, Saito, T, Kamiura, S, Iwata, T, Mikami, M & Sugiyama, T 2018, 'Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer', International Journal of Cancer, vol. 142, no. 5, pp. 1022-1032. https://doi.org/10.1002/ijc.31084
Matsuo, Koji ; Shimada, Muneaki ; Yamaguchi, Satoshi ; Kanao, Hiroyuki ; Nakanishi, Toru ; Saito, Toshiaki ; Kamiura, Shoji ; Iwata, Takashi ; Mikami, Mikio ; Sugiyama, Toru. / Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer. In: International Journal of Cancer. 2018 ; Vol. 142, No. 5. pp. 1022-1032.
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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.",
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