Matsuo K, et al. - Researchers here aimed to assess 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. In this study, there appeared no risk factor for ovarian metastasis or adenocarcinoma alone among nearly two-thirds of women aged <50 years with clinical stage IB-IIB cervical cancer. These subgroups had ovarian metastasis rates of around 0.1% and could be a candidate population for ovarian conservation at surgical treatment.

Methods

• Researchers performed a nation-wide multicenter retrospective study in Japan.
• The study examined consecutive cases of surgically-treated women with clinical stage IB-IIB cervical cancer who had oophorectomy at radical hysterectomy (n=5,697).
• Independent risk factors for ovarian metastasis were identified with multivariable analysis.

Results

• 70 cases indicated ovarian metastasis(1.2%, 95% confidence interval 0.9-1.5).
• In the entire cohort, for ovarian metastasis, independent risk factors included adenocarcinoma, lympho-vascular space invasion, uterine corpus tumor invasion, and pelvic/para-aortic nodal metastases (all, adjusted-P<0.05).
• A sensitivity analysis of 3,165 women aged <50 years (ovarian metastasis, 1.0%) identified adenocarcinoma, parametrial tumor involvement, uterine corpus tumor involvement, and pelvic/para-aortic nodal metastases as independent risk factors for ovarian metastasis (all, adjusted-P<0.05).
• The incidence of ovarian metastasis was 0.14% in the absence of these five risk factors (representing 46.1% of women aged <50 years).
• The presence of adenocarcinoma alone (representing 18.9% of women aged <50 years) indicated the incidence of ovarian metastasis of 0.17% and this was not associated with increased risk of ovarian metastasis compared to the subgroup without any risk factors (P=0.87).