Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer

被引：22

作者：

Matsuo, Koji ^{[1
]}

Cripe, James C. ^{[2
]}

Kurnit, Katherine C. ^{[3
]}

Kaneda, Michiko ^{[4
]}

Garneau, Audrey S. ^{[5
]}

Glaser, Gretchen E. ^{[6
]}

Nizam, Aaron ^{[7
]}

Schillinger, Rachel M. ^{[8
]}

Kuznicki, Michelle L. ^{[9
]}

Yabuno, Akira ^{[10
]}

Yanai, Shiori ^{[11
]}

Garofalo, Denise M. ^{[12
]}

Suzuki, Jiro ^{[13
]}

St Laurent, Jessica D. ^{[14
]}

Yen, Ting-Tai ^{[15
]}

Liu, Annie Y. ^{[16
]}

Shida, Masako ^{[17
]}

Kakuda, Mamoru ^{[18
]}

Oishi, Tetsuro ^{[19
]}

Nishio, Shin ^{[20
]}

Marcus, Jenna Z. ^{[21
]}

Adachi, Sosuke ^{[22
]}

Kurokawa, Tetsuji ^{[23
]}

Ross, Malcolm S. ^{[24
]}

Horowitz, Max P. ^{[25
]}

Johnson, Marian S. ^{[5
]}

Kim, Min K. ^{[8
]}

Melamed, Alexander ^{[14
]}

Machado, Karime K. ^{[15
]}

Yoshihara, Kosuke ^{[22
]}

Yoshida, Yoshio ^{[23
]}

Enomoto, Takayuki ^{[22
]}

Ushijima, Kimio ^{[20
]}

Satoh, Shinya ^{[19
]}

Ueda, Yutaka ^{[18
]}

Mikami, Mikio ^{[17
]}

Rimel, Bobbie J. ^{[16
]}

Stone, Rebecca L. ^{[15
]}

Growdon, Whitfield B. ^{[14
]}

Okamoto, Aikou ^{[13
]}

Guntupalli, Saketh R. ^{[12
]}

Hasegawa, Kosei ^{[10
]}

Shahzad, Mian M. K. ^{[9
]}

Im, Dwight D. ^{[8
]}

Frimer, Marina ^{[7
]}

Gostout, Bobbie S. ^{[6
]}

Ueland, Frederick R. ^{[5
]}

Nagao, Shoji ^{[4
]}

Soliman, Pamela T. ^{[3
]}

Thaker, Premal H. ^{[2
]}

机构：

[1] Univ Southern Calif, Dept Obstet & Gynecol, Div Gynecol Oncol, 2020 Zonal Ave,IRD 520, Los Angeles, CA 90033 USA

[2] Washington Univ, Sch Med, Dept Obstet & Gynecol, Div Gynecol Oncol, St Louis, MO 63110 USA

[3] Univ Texas MD Anderson Canc Ctr, Dept Gynecol Oncol & Reprod Med, Houston, TX 77030 USA

[4] Hyogo Canc Ctr, Dept Gynecol, Akashi, Hyogo, Japan

[5] Univ Kentucky, Dept Obstet & Gynecol, Div Gynecol Oncol, Lexington, KY USA

[6] Mayo Clin, Div Gynecol Oncol, Dept Surg, Rochester, MN USA

[7] Northwell Hlth, Zucker Sch Med Hofstra Northwell, Dept Obstet & Gynecol, Div Gynecol Oncol, Island, NY USA

[8] Mercy Med Ctr, Gynecol Oncol Ctr, Baltimore, MD USA

[9] Univ S Florida, Moffitt Canc Ctr, Dept Obstet & Gynecol, Div Gynecol Oncol, Tampa, FL 33620 USA

[10] Saitama Med Univ, Dept Gynecol Oncol, Int Med Ctr, Saitama, Japan

[11] Kurashiki Med Ctr, Dept Obstet & Gynecol, Okayama, Japan

[12] Univ Colorado, Dept Obstet & Gynecol, Div Gynecol Oncol, Denver, CO USA

[13] Jikei Univ, Dept Obstet & Gynecol, Sch Med, Tokyo, Japan

[14] Harvard Med Sch, Massachusetts Gen Hosp, Dept Obstet & Gynecol, Div Gynecol Oncol, Boston, MA 02115 USA

[15] Johns Hopkins Med, Div Gynecol Oncol, Dept Obstet & Gynecol, Baltimore, MD USA

[16] Cedars Sinai Med Ctr, Dept Obstet & Gynecol, Div Gynecol Oncol, Los Angeles, CA 90048 USA

[17] Tokai Univ, Dept Obstet & Gynecol, Sch Med, Hiratsuka, Kanagawa, Japan

[18] Osaka Univ, Dept Obstet & Gynecol, Grad Sch Med, Osaka, Japan

[19] Tottori Univ, Dept Obstet & Gynecol, Sch Med, Tottori, Japan

[20] Kurume Univ, Dept Obstet & Gynecol, Sch Med, Fukuoka, Fukuoka, Japan

[21] Rutgers New Jersey Med Sch, Dept Obstet & Gynecol, Div Gynecol Oncol, Newark, NJ USA

[22] Niigata Univ, Dept Obstet & Gynecol, Sch Med, Niigata, Japan

[23] Univ Fukui, Dept Obstet & Gynecol, Sch Med, Fukui, Japan

[24] Univ Pittsburgh, Magee Womens Hosp, Dept Obstet & Gynecol, Div Gynecol Oncol, Pittsburgh, PA 15213 USA

[25] Cleveland Clin, Dept Obstet & Gynecol, Div Gynecol Oncol, Cleveland, OH 44106 USA

[26] Columbia Univ Coll Phys & Surg, Dept Obstet & Gynecol, Div Gynecol Oncol, New York, NY 10032 USA

来源：

GYNECOLOGIC ONCOLOGY | 2019年 / 155卷 / 01期

关键词：

Endometrial cancer; Ovarian conservation; Recurrence; Survival; Secondary primary cancer; PREMENOPAUSAL WOMEN; SURVIVAL; RISK; PRESERVATION; OOPHORECTOMY; ADENOCARCINOMA; MORTALITY; PATTERNS; OUTCOMES; THERAPY;

D O I：

10.1016/j.ygyno.2019.08.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective. To examine the association between ovarian conservation and oncologic outcome in surgically-treated young women with early-stage, low-grade endometrial cancer. Methods. This multicenter retrospective study examined women aged <50 with stage 1 grade 1-2 endometrioid endometrial cancer who underwent primary surgery with hysterectomy from 2000 to 2014 (US cohort n = 1196, and Japan cohort n = 495). Recurrence patterns, survival, and the presence of a metachronous secondary malignancy were assessed based on ovarian conservation versus oophorectomy. Results. During the study period, the ovarian conservation rate significantly increased in the US cohort from 5.4% to 16.4% (P = 0.020) whereas the rate was unchanged in the Japan cohort (6.3-8.7%, P = 0.787). In the US cohort, ovarian conservation was not associated with disease-free survival (hazard ratio 11-112] 0.829, 95% confidence interval [CI] 0.188-3.663, P = 0.805), overall survival (HR not estimated, P = 0.981), or metachronous secondary malignancy (HR 1.787, 95% CI 0.603-5.295, P = 0.295). In the Japan cohort, ovarian conservation was associated with decreased disease-free survival (HR 5.214, 95%CI 1.557-17.464, P = 0.007) and an increased risk of a metachronous secondary malignancy, particularly ovarian cancer (HR 7.119, 95% CI 1.349-37.554, P = 0.021), but was not associated with overall survival (HR not estimated, P = 0.987). Ovarian recurrence or metachronous secondary ovarian cancer occurred after a median time of 5.9 years, and all cases were salvaged. Conclusion. Our study suggests that adoption of ovarian conservation in young women with early-stage low-grade endometrial cancer varies by population. Ovarian conservation for young women with early-stage, low-grade endometrial cancer may be potentially associated with increased risks of ovarian recurrence or metachronous secondary ovarian cancer in certain populations; nevertheless, ovarian conservation did not negatively impact overall survival. (C) 2019 Published by Elsevier Inc.

引用

页码：39 / 50

页数：12

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