Abstract
BackgroundEpithelial ovarian cancer (EOC) is an extremely aggressive and lethal carcinoma. Specific data that identify high-risk groups with uterine involvement are not available. Thus, this study aimed to evaluate a gross number of women with EOC to obtain the frequency of uterine involvement and its risk factors.MethodsThis retrospective observational study was conducted on 1900 histologically confirmed EOC women, diagnosed and treated in our tertiary hospital from March 2009 to September 2020. Data including their demographic, medical and pathological findings were collected.ResultsFrom 1900 histologically confirmed EOC women, 347 patients were eligible for participations. The mean age of study patients was 51.31 ± 11.37 years with the age range of 25 to 87 years. Uterine involvement was detected in 49.6% (173) of the patients either macroscopic (47.4%) or microscopic (52.6%) types.Uterine involvement was significantly associated with having AUB (P-value = 0.002), histological type of ovary tumor (P-value < 0.001), ovarian cancer stage (P-value < 0.001), and abnormal CA-125 concentration (P-value = 0.004).Compared to the other study patient, the patients with metastatic uterine involvement had significantly higher stage (p-value< 0.001), higher grade of ovary tumor (p-value = 0.008), serous histological type (p-value< 0.001), and a higher level of CA-125 concentration (p-value< 0.001).on the other hand, the patients with synchronous uterine cancer were significantly younger (p-value = 0.013), nulliparous (p-value< 0.001), suffered from AUB symptoms (p-value< 0.001) and had endometroid histological type (p-value = 0.010) of ovary cancer in comparison to other study patients.ConclusionConsidering the high prevalence of uterine involvement in EOC patients, ultrasound evaluation and/or endometrium biopsy assessment should be done before planning any treatment.
Highlights
Epithelial ovarian cancer (EOC) is an extremely aggressive and lethal carcinoma
Considering the high prevalence of uterine involvement in EOC patients, ultrasound evaluation and/or endometrium biopsy assessment should be done before planning any treatment
From among all histologically confirmed EOC women who were referred to our oncology department, the ones on whom hysterectomy as a debulking primary surgery was performed, enrolled in the study
Summary
Epithelial ovarian cancer (EOC) is an extremely aggressive and lethal carcinoma. This study aimed to evaluate a gross number of women with EOC to obtain the frequency of uterine involvement and its risk factors. Epithelial ovarian cancer (EOC) is an extremely aggressive and lethal tumor, mostly diagnosed in advanced stages with poor prognosis except in small number of patients with early detection [1]. 10% of all patients with EOC seem to have concurrent endometrial cancer, which are the most common synchronous gynecologic tumors. Concurrent uterine involvement in EOC patients is mostly observed in younger nulliparous women with lower ovary tumor stage [1,2,3]. Hysterectomy is usually used in primary debulking surgery in advanced invasive EOC management. There is no clear logical reason, at least, preoperative recognition of patients according to uterine involvement could be helpful for selecting hysterectomy type (total or subtotal) [7,8,9,10]
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