Ovarian Metastasis in Carcinoma of the Uterine Cervix

Abstract

The goal of this study was to determine the frequency and histopathology of ovarian metastases in 3471 women having stage IB to IIB cervical cancer who underwent radical hysterectomy, pelvic lymph node dissection, and bilateral salpingo-oophorectomy in the years 1981 to 2000. Ovarian metastases were found in 52 women, 1.5% of the study population. Six patients with metastases had stage IB1 cervical cancer; 12, stage IB2 disease; 5, stage IIA disease; and 29, stage IIB cervical cancer. Incidence rates of ovarian metastasis progressed from 0.2% for those with stage IB disease to 2.2% for patients having stage IIb squamous cell carcinoma; and from 3.7% to 9.85%, respectively, for those with adenocarcinoma. Patients with adenocarcinoma were more likely than those with squamous cell cancer to have ovarian metastases (5.3% vs 0.8%). Outcomes were, in general, very poor and were not related to either the stage of cervical cancer or histologic type. No correlation was evident between ovarian metastasis and either lymph node involvement or parametrial invasion. The most common sites of distant recurrence were bone and lung. Five-year survival rates were 18% for patients having adenocarcinoma and 43.5% for those with squamous cell carcinoma. The investigators believe that the ovaries may be preserved in women having stage IB to IIA squamous cell carcinoma of the cervix but recommend that they be removed in those with adenocarcinoma.