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

Autor: Matsuo K; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA. Electronic address: koji.matsuo@med.usc.edu., Cripe JC; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA., Kurnit KC; Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA., Kaneda M; Department of Gynecology, Hyogo Cancer Center, Hyogo, Japan., Garneau AS; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY, USA., Glaser GE; Division of Gynecologic Oncology, Department of Surgery, Mayo Clinic, Rochester, MN, USA., Nizam A; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Long Island, NY, USA., Schillinger RM; Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA., Kuznicki ML; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, FL, USA., Yabuno A; Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan., Yanai S; Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan., Garofalo DM; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA., Suzuki J; Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan., St Laurent JD; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Yen TT; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Johns Hopkins Medicine, Baltimore, MD, USA., Liu AY; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Shida M; Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan., Kakuda M; Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan., Oishi T; Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan., Nishio S; Department of Obstetrics and Gynecology, Kurume University School of Medicine, Fukuoka, Japan., Marcus JZ; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Rutgers New Jersey Medical School, Newark, NJ, USA., Adachi S; Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan., Kurokawa T; Department of Obstetrics and Gynecology, University of Fukui School of Medicine, Fukui, Japan., Ross MS; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, PA, USA., Horowitz MP; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA., Johnson MS; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY, USA., Kim MK; Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA., Melamed A; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Machado KK; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Johns Hopkins Medicine, Baltimore, MD, USA., Yoshihara K; Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan., Yoshida Y; Department of Obstetrics and Gynecology, University of Fukui School of Medicine, Fukui, Japan., Enomoto T; Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan., Ushijima K; Department of Obstetrics and Gynecology, Kurume University School of Medicine, Fukuoka, Japan., Satoh S; Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan., Ueda Y; Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan., Mikami M; Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan., Rimel BJ; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Stone RL; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Johns Hopkins Medicine, Baltimore, MD, USA., Growdon WB; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Okamoto A; Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan., Guntupalli SR; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA., Hasegawa K; Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan., Shahzad MMK; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Moffitt Cancer Center, University of South Florida, FL, USA., Im DD; Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA., Frimer M; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Long Island, NY, USA., Gostout BS; Division of Gynecologic Oncology, Department of Surgery, Mayo Clinic, Rochester, MN, USA., Ueland FR; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY, USA., Nagao S; Department of Gynecology, Hyogo Cancer Center, Hyogo, Japan., Soliman PT; Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA., Thaker PH; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA., Wright JD; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA., Roman LD; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2019 Oct; Vol. 155 (1), pp. 39-50. Date of Electronic Publication: 2019 Aug 16.
DOI: 10.1016/j.ygyno.2019.08.007
Abstrakt: 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 I 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 [HR] 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.
(Copyright © 2019. Published by Elsevier Inc.)
Databáze: MEDLINE
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