Effect of bilateral salpingo-oophorectomy on the overall survival of premenopausal patients with stage I low-grade endometrial stromal sarcoma; a National Cancer Database analysis
| Autor: | Nawar A. Latif, S.H. Kim, Ashley Haggerty, Mark A. Morgan, Spyridon A. Mastroyannis, Emily M. Ko, Robert L. Giuntoli nd, Dimitrios Nasioudis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Adolescent Databases Factual Sarcoma Endometrial Stromal medicine.medical_treatment Salpingo-oophorectomy Ovary Young Adult 03 medical and health sciences 0302 clinical medicine Humans Medicine Stage (cooking) Neoplasm Staging Retrospective Studies Gynecology Chemotherapy Endometrial stromal sarcoma Hysterectomy business.industry Obstetrics and Gynecology Cancer Middle Aged medicine.disease Survival Analysis 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Hormonal therapy Female Sarcoma Neoplasm Grading business |
| Zdroj: | Gynecologic Oncology. 157:634-638 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2020.04.001 |
| Popis: | Investigate the prevalence of bilateral salpingo-oophorectomy (BSO) for women ≤50 years with early stage low-grade endometrial stromal sarcoma (LGESS) and its impact on overall survival (OS).Women ≤50 years, diagnosed with stage I LGESS and managed with hysterectomy between 2004 and 2015 were identified from the National Cancer Database. Patient demographics were recorded and compared with the chi-square test. OS for patients diagnosed between 2004 and 2014 with at least one month of follow-up was assessed using Kaplan-Meier curves, and compared with the log-rank test.A total 743 patients with a median age of 44 years met the inclusion criteria. Use of radiatiotherapy (9%), chemotherapy (0.8%) and hormonal therapy (11%) was infrequent. BSO was performed in 541 (72.8%) patients. Patients who had ovarian preservation (OP) were younger (median age 43 vs 45 years, p 0.001), less likely to have comorbidities (6.9% vs 12.4%, p = 0.034), or undergo LND (30.7% vs 44.4%, p = 0.001). There were no differences between the two groups in terms of substage or patient race. Five year OS rates for patients who did (n = 490) and did not (n = 191) undergo BSO were 96.2% and 97.1% and there was no difference in OS, p = 0.50. Even after controlling for presence of comorbidities performance of BSO was not associated with better survival (HR: 1.28, 95% CI: 0.51, 3.19).Ovarian function was preserved in approximately one third of women ≤50 years with stage I LGESS with no clear detriment to overall survival. As BSO is associated with long term health effects in this patient population OP could be considered in selected women with stage I LGESS. |
| Databáze: | OpenAIRE |
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