Health Management Department, West China Hospital of Sichuan University, Chengdu, China.
Obstetrics and Gynecology Department, West China Second University Hospital, Sichuan University, Chengdu, China.
Acta Obstet Gynecol Scand. 2019 Jan;98(1):18-23. doi: 10.1111/aogs.13442. Epub 2018 Oct 24.
Cervical cancer is a common malignant tumor in women; most cervical cancer patients are premenopausal. Ovarian resection or preservation remains controversial. The purpose of this study was to discover the risk factors for ovarian metastasis in women with stage I-II cervical cancer.
A total of 3292 women with cervical carcinoma who had undergone radical hysterectomy, with pelvic lymphadenectomy and bilateral oophorectomy or wedge resection of ovaries, were included in this multicenter retrospective study. We analyzed patients' demographics, International Federation of Obstetrics and Gynecology stage, and histopathologic records to determine clinicopathologic risk factors of ovarian metastasis.
Of the patients, 115 (3.49%) were confirmed to have ovarian metastasis. The ovarian metastasis rate was 2% (56/2794) for squamous cell carcinoma and 11.8% (59/498) for nonsquamous cell carcinoma. The risk factors independently associated with ovarian metastasis were histologic type (odds ratio [OR] 8.76, 95% CI 2.09-19.24), lymph node metastasis (OR 2.57, 95% CI 1.76-4.89), lymphovascular space invasion (OR 2.82, 95% CI 1.98-4.24), and corpus invasion (OR 6.34, 95% CI 2.37-11.42).
The histologic type, lymph node metastasis, lymphovascular space invasion, and corpus invasion were independently associated with ovarian metastasis. Histologic type and corpus invasion were the most important risk factors. Therefore, we suggest that corpus invasion might be a strong contraindication for preservation of the ovaries.
宫颈癌是女性常见的恶性肿瘤；大多数宫颈癌患者处于绝经前。卵巢切除术或保留术仍存在争议。本研究旨在发现Ⅰ-Ⅱ期宫颈癌患者卵巢转移的危险因素。
共纳入 3292 例接受根治性子宫切除术、盆腔淋巴结切除术和双侧卵巢切除术或卵巢楔形切除术的宫颈癌患者，该多中心回顾性研究分析了患者的人口统计学、国际妇产科联合会分期和组织病理学记录，以确定卵巢转移的临床病理危险因素。
在患者中，有 115 例（3.49%）被证实存在卵巢转移。鳞癌的卵巢转移率为 2%（56/2794），非鳞癌的卵巢转移率为 11.8%（59/498）。与卵巢转移独立相关的危险因素是组织学类型（优势比 [OR] 8.76，95%置信区间 2.09-19.24）、淋巴结转移（OR 2.57，95%置信区间 1.76-4.89）、淋巴管血管间隙浸润（OR 2.82，95%置信区间 1.98-4.24）和宫体侵犯（OR 6.34，95%置信区间 2.37-11.42）。
组织学类型、淋巴结转移、淋巴管血管间隙浸润和宫体侵犯与卵巢转移独立相关。组织学类型和宫体侵犯是最重要的危险因素。因此，我们建议宫体侵犯可能是保留卵巢的强烈禁忌证。
