Ovarian metastases in stage Ib to IIb carcinoma of the uterine cervix

Abstract

5061 Background: Recently, uterine cervical cancer has increased in young women. The management of ovaries is important in patients with cervical cancer. In the previous studies, the number of patients with cervical cancer was too small to draw conclusion about the impact of various clinicopathologic features in ovarian metastases. We conducted the present review to determine clinicopathological features in over 3,000 patients with cervical cancer who underwent radical hysterectomy included bilateral salpingo-oophorectomy. The present study involved the largest series of patients with ovarian metastases. Methods: A total of 3,352 patients with stage Ib to IIb cervical cancer underwent radical hysterectomy included bilateral salpingo-oophorectomy between 1980 and 2002 in our 5 institutes. All patients were identified by the medical records. Of 3,352 patients with cervical cancer, 42 (1.3%) had ovarian metastases. The clinicopathological features in those patients were examined. Results: The mean age of patients with ovarian metastases was 52.5 years (range: 29–73 years). Out of 42 cases, there were 12 in stage Ib, 5 in stage IIa, and 25 in stage IIb. No patients with stage Ib1 squamous cell carcinoma had ovarian metastases. The incidence of ovarian metastases was shown in Table. Ovarian metastases were more frequently in adenocarcinoma than that in squamous cell carcinoma (3.91% vs. 0.76%). The 5-year survival rate was 40.1% for stage Ib, 66.7%, for stage IIa, and 23.6% for stage IIb in patients with ovarian metastases. The side of ovarian metastases did not correlate with the side of lymphnode involvement or paracolpium invasion. Conclusions: The present study indicates that ovaries in stage Ib-IIa patients with squamous cell carcinoma can be preserved. In contrast, patients with cervical adenocarcinoma are recommended to remove ovaries. No significant financial relationships to disclose.