The Safety of Ovarian Preservation in Early-Stage Adenocarcinoma Compared With Squamous Cell Carcinoma of Uterine Cervix: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

Although the incidence of OM was higher in early-stage ADC than SCC according to ovarian pathology, it might be relatively safe to perform ovarian preservation with early-stage ADC because of low ovarian recurrence rate in short-term follow-ups.

Identifying a candidate population for ovarian conservation in young women with clinical stage IB–IIB cervical cancer

“…That is, the adenocarcinoma type is anatomically closer to the ovary compared to the squamous type with increased risk of uterine corpus tumor invasion resulting in a higher incidence of ovarian metastasis compared to the squamous type. This finding validates our previous study and others including a systematic literature review . Because our study examined a significantly larger sample size, our study is more reassuring to endorse this association.…”

“…8,14 A concern for ovarian conservation at surgical treatment for women with cervical cancer is a possibility of leaving tumor already metastasized to the ovary. While the risk of ovarian metastasis seems low as demonstrated in multiple prior studies, [15][16][17][18][19][20][21] there is currently little reliable risk stratification available for the prediction of ovarian metastasis, especially in stages IB-IIB disease. Because ovarian conservation at the time of surgical treatment can potentially impact woman's health and there are likely a substantial number of women who are candidates for ovarian conservation at surgery, establishing a risk stratification model of ovarian metastasis is of utmost importance in the management of young women with cervical cancer when surgical treatment is scheduled.…”

Ovarian conservation for young women with clinical stage IB–IIB cervical cancer in Japan

“…In review of the literature, there is an increased risk of ovarian metastasis with adenocarcinoma histology as compared to squamous type reported in multiple studies [6789]. Likely reflecting this evidence, women with adenocarcinoma type had a minimal rate of ovarian conservation in this study population (0.1%).…”

“…Likely reflecting this evidence, women with adenocarcinoma type had a minimal rate of ovarian conservation in this study population (0.1%). However, a recent meta-analysis of 5 studies showed that ovarian recurrence was not observed after ovarian conservation for early-stage (carcinoma in situ [CIS] to stage IIA) cervical adenocarcinoma [9]. Moreover, a population-based study showed that CSS from early-stage cervical adenocarcinoma was similar between the ovarian conservation group and the oophorectomy group (aHR=0.90; 95% CI=0.50–1.61) [7].…”

“…In our study, there were only 2 women with adenocarcinoma histology who had ovarian conservation, and survival outcome of this subgroup was not assessable. Given that the absolute incidence of ovarian metastasis remains relatively low even in adenocarcinoma type (2.0%–3.7%) [79], ovarian conservation may need to be considered even in adenocarcinoma histology when there is absence of additional risk factors for ovarian metastasis [8]. …”