Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 6/2019

28.03.2019 | Gynecologic Oncology

Utero-ovarian preservation and overall survival of young women with early-stage borderline ovarian tumors

verfasst von: Rachel S. Mandelbaum, Erin A. Blake, Hiroko Machida, Brendan H. Grubbs, Lynda D. Roman, Koji Matsuo

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To examine survival of women who had uterine and ovarian preservation during surgical treatment for early-stage borderline ovarian tumors (BOTs).

Methods

The Surveillance, Epidemiology, and End Results Program was used to identify women aged < 50 years with stage I BOTs who underwent ovarian conservation at surgical treatment between 1988 and 2003. Survival outcomes were examined based on the use of concurrent hysterectomy at surgery.

Results

Among 6379 cases of BOT, there were 1065 women who had utero-ovarian preservation at surgery, and there were 52 women who had hysterectomy with ovarian preservation alone. Women who had uterine preservation were more likely to be single and diagnosed in recent years (both, P < 0.05). On univariable analysis, women who had utero-ovarian preservation had cause-specific survival similar to those who had ovarian preservation alone without uterine preservation (10-year rates: 99.2% versus 98.1%, P = 0.42); however, overall survival was higher in the utero-ovarian preservation group compared to the hysterectomy group (95.8% versus 87.6%, P < 0.001). On multivariable analysis, utero-ovarian preservation remained an independent prognostic factor for improved overall survival (adjusted hazard ratio 0.35, 95% confidence interval 0.15–0.79, P = 0.012). Cardiovascular disease mortality was lower in the utero-ovarian preservation group compared to the hysterectomy group, but it did not reach statistical significance (20-year cumulative rate, 0.8% versus 3.0%, P = 0.29).

Conclusion

Our study suggests that utero-ovarian preservation for young women with early-stage BOTs may be associated with improved overall survival compared to ovarian preservation alone without affecting BOT-related survival outcome.
Literatur
1.
Zurück zum Zitat Taylor HC (1929) Malignant and semi-malignant tumors of the ovary. Surg Gynecol Obstet 48:701–712 Taylor HC (1929) Malignant and semi-malignant tumors of the ovary. Surg Gynecol Obstet 48:701–712
2.
Zurück zum Zitat International Federation of Gynecology and Obstetrics (1971) Classification and staging of malignant tumors in the female pelvis. Acta Obstet Gynecol Scand 50:1–12 International Federation of Gynecology and Obstetrics (1971) Classification and staging of malignant tumors in the female pelvis. Acta Obstet Gynecol Scand 50:1–12
3.
Zurück zum Zitat Harter P, Gershenson D, Lhomme C et al (2014) Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian tumors of low malignant potential (borderline ovarian tumors). Int J Gynecol Cancer. 24(9 Suppl 3):S5–S8CrossRefPubMed Harter P, Gershenson D, Lhomme C et al (2014) Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian tumors of low malignant potential (borderline ovarian tumors). Int J Gynecol Cancer. 24(9 Suppl 3):S5–S8CrossRefPubMed
4.
5.
Zurück zum Zitat Sherman ME, Mink PJ, Curtis R, Cote TR, Brooks S, Hartge P, Devesa S (2004) Survival among women with borderline ovarian tumors and ovarian carcinoma: a population-based analysis. Cancer 100:1045–1052CrossRefPubMed Sherman ME, Mink PJ, Curtis R, Cote TR, Brooks S, Hartge P, Devesa S (2004) Survival among women with borderline ovarian tumors and ovarian carcinoma: a population-based analysis. Cancer 100:1045–1052CrossRefPubMed
6.
Zurück zum Zitat Matsuo K, Sood AK, Gershenson DM (2015) Management of early-stage ovarian cancer. In: Bristow RE, Karlan BY (eds) Surgery for ovarian cancer: principles and practice. pp 67–104 Matsuo K, Sood AK, Gershenson DM (2015) Management of early-stage ovarian cancer. In: Bristow RE, Karlan BY (eds) Surgery for ovarian cancer: principles and practice. pp 67–104
7.
Zurück zum Zitat Menczer J, Chetrit A, Sadetzki S (2012) The effect of hysterectomy on survival of patients with borderline ovarian tumors. Gynecol Oncol 125:372–375CrossRefPubMed Menczer J, Chetrit A, Sadetzki S (2012) The effect of hysterectomy on survival of patients with borderline ovarian tumors. Gynecol Oncol 125:372–375CrossRefPubMed
8.
Zurück zum Zitat Ouldamer L, Lacoste C, Cormier B, Arbion F, Marret H, Jallais L, Fignon A, Body G (2016) Is there a justification for hysterectomy in patients with borderline ovarian tumors? Surg Oncol 25:1–5CrossRefPubMed Ouldamer L, Lacoste C, Cormier B, Arbion F, Marret H, Jallais L, Fignon A, Body G (2016) Is there a justification for hysterectomy in patients with borderline ovarian tumors? Surg Oncol 25:1–5CrossRefPubMed
9.
Zurück zum Zitat Kennedy AW, Hart WR (1996) Ovarian papillary serous tumors of low malignant potential (serous borderline tumors). A long-term follow-up study, including patients with microinvasion, lymph node metastasis, and transformation to invasive serous carcinoma. Cancer 78:278–286CrossRefPubMed Kennedy AW, Hart WR (1996) Ovarian papillary serous tumors of low malignant potential (serous borderline tumors). A long-term follow-up study, including patients with microinvasion, lymph node metastasis, and transformation to invasive serous carcinoma. Cancer 78:278–286CrossRefPubMed
10.
Zurück zum Zitat Fotopoulou C, Schumacher G, Schefold JC, Denkert C, Lichtenegger W, Sehouli J (2009) Systematic evaluation of the intraoperative tumor pattern in patients with borderline tumor of the ovary. Int J Gynecol Cancer 19:1550–1555CrossRefPubMed Fotopoulou C, Schumacher G, Schefold JC, Denkert C, Lichtenegger W, Sehouli J (2009) Systematic evaluation of the intraoperative tumor pattern in patients with borderline tumor of the ovary. Int J Gynecol Cancer 19:1550–1555CrossRefPubMed
11.
Zurück zum Zitat Messalli EM, Grauso F, Balbi G, Napolitano A, Seguino E, Torella M (2012) Borderline ovarian tumors: features and controversial aspects. Eur J Obstet Gynecol Reprod Biol 167:86–89CrossRefPubMed Messalli EM, Grauso F, Balbi G, Napolitano A, Seguino E, Torella M (2012) Borderline ovarian tumors: features and controversial aspects. Eur J Obstet Gynecol Reprod Biol 167:86–89CrossRefPubMed
13.
Zurück zum Zitat Lin PS, Gershenson DM, Bevers MW, Lucas KR, Burke TW, Silva EG (1999) The current status of surgical staging of ovarian serous borderline tumors. Cancer 85:905–911CrossRefPubMed Lin PS, Gershenson DM, Bevers MW, Lucas KR, Burke TW, Silva EG (1999) The current status of surgical staging of ovarian serous borderline tumors. Cancer 85:905–911CrossRefPubMed
15.
Zurück zum Zitat Daraï E, Fauvet R, Uzan C, Gouy S, Duvillard P, Morice P (2013) Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options. Hum Reprod Update. 19(2):151–166CrossRefPubMed Daraï E, Fauvet R, Uzan C, Gouy S, Duvillard P, Morice P (2013) Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options. Hum Reprod Update. 19(2):151–166CrossRefPubMed
16.
Zurück zum Zitat Matsuo K, Machida H, Takiuchi T et al (2017) Role of hysterectomy and lymphadenectomy in the management of early-stage borderline ovarian tumors. Gynecol Oncol 144(3):496–502CrossRefPubMedPubMedCentral Matsuo K, Machida H, Takiuchi T et al (2017) Role of hysterectomy and lymphadenectomy in the management of early-stage borderline ovarian tumors. Gynecol Oncol 144(3):496–502CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Shazly SA, Laughlin-Tommaso SK, Dowdy SC, Famuyide AO (2016) Staging for low malignant potential ovarian tumors: a global perspective. Am J Obstet Gynecol 215(153–168):e2 Shazly SA, Laughlin-Tommaso SK, Dowdy SC, Famuyide AO (2016) Staging for low malignant potential ovarian tumors: a global perspective. Am J Obstet Gynecol 215(153–168):e2
19.
Zurück zum Zitat von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 335:806–808CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 335:806–808CrossRef
20.
Zurück zum Zitat Lesieur B, Kane A, Duvillard P, Gouy S, Pautier P, Lhomme C, Morice P, Uzan C (2011) Prognostic value of lymph node involvement in ovarian serous borderline tumors. Am J Obstet Gynecol 204(438):e1–e7 Lesieur B, Kane A, Duvillard P, Gouy S, Pautier P, Lhomme C, Morice P, Uzan C (2011) Prognostic value of lymph node involvement in ovarian serous borderline tumors. Am J Obstet Gynecol 204(438):e1–e7
23.
Zurück zum Zitat Beahrs OH, Henson DE, Hutter RVP, Myers MH (eds) (1988) Manual for staging of cancer, 3rd edn. American Joint Committee on Cancer, Lippincott Press, Philadephia, pp 163–168 Beahrs OH, Henson DE, Hutter RVP, Myers MH (eds) (1988) Manual for staging of cancer, 3rd edn. American Joint Committee on Cancer, Lippincott Press, Philadephia, pp 163–168
25.
Zurück zum Zitat Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef
26.
Zurück zum Zitat Cox DR (1972) Regression models and life-tables. J R Stat Soc Series B Stat Methodol 34:187–220 Cox DR (1972) Regression models and life-tables. J R Stat Soc Series B Stat Methodol 34:187–220
27.
Zurück zum Zitat Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR (1996) A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 49:1373–1379CrossRefPubMed Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR (1996) A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 49:1373–1379CrossRefPubMed
28.
29.
Zurück zum Zitat Mansfield ER, Helms BP (1982) Detecting multicollinearity. Am Stat 36:158–160 Mansfield ER, Helms BP (1982) Detecting multicollinearity. Am Stat 36:158–160
30.
Zurück zum Zitat Vasconcelos I, de Sousa Mendes M (2015) Conservative surgery in ovarian borderline tumours: a meta-analysis with emphasis on recurrence risk. Eur J Cancer 51(5):620–631CrossRefPubMed Vasconcelos I, de Sousa Mendes M (2015) Conservative surgery in ovarian borderline tumours: a meta-analysis with emphasis on recurrence risk. Eur J Cancer 51(5):620–631CrossRefPubMed
31.
Zurück zum Zitat Farquhar CM, Sadler L, Harvey SA, Stewart AW (2005) The association of hysterectomy and menopause: a prospective cohort study. BJOG: Int J Obstet Gynaecol. 112(7):956–962CrossRefPubMed Farquhar CM, Sadler L, Harvey SA, Stewart AW (2005) The association of hysterectomy and menopause: a prospective cohort study. BJOG: Int J Obstet Gynaecol. 112(7):956–962CrossRefPubMed
32.
Zurück zum Zitat Moorman PG, Myers ER, Schildkraut JM, Iversen ES, Wang F, Warren N (2011) Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol 118(6):1271–1279CrossRefPubMedPubMedCentral Moorman PG, Myers ER, Schildkraut JM, Iversen ES, Wang F, Warren N (2011) Effect of hysterectomy with ovarian preservation on ovarian function. Obstet Gynecol 118(6):1271–1279CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Xiangying H, Lili H, Yifu PS (2006) The effect of hysterectomy on ovarian blood supply and endocrine function. Climacteric. 9(4):283–289CrossRefPubMed Xiangying H, Lili H, Yifu PS (2006) The effect of hysterectomy on ovarian blood supply and endocrine function. Climacteric. 9(4):283–289CrossRefPubMed
34.
Zurück zum Zitat Rivera CM, Grossardt BR, Rhodes DJ et al (2009) Increased cardiovascular mortality following early bilateral oophorectomy. Menopause. 16(1):15–23CrossRefPubMedPubMedCentral Rivera CM, Grossardt BR, Rhodes DJ et al (2009) Increased cardiovascular mortality following early bilateral oophorectomy. Menopause. 16(1):15–23CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Rocca WA, Grossardt BR, de Andrade M, Malkasian GD, Melton LJ (2006) Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol. 7(10):821–828CrossRefPubMed Rocca WA, Grossardt BR, de Andrade M, Malkasian GD, Melton LJ (2006) Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol. 7(10):821–828CrossRefPubMed
36.
Zurück zum Zitat Palomba S, Zupi E, Russo T et al (2007) Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study. Hum Reprod 22(2):578–585CrossRefPubMed Palomba S, Zupi E, Russo T et al (2007) Comparison of two fertility-sparing approaches for bilateral borderline ovarian tumours: a randomized controlled study. Hum Reprod 22(2):578–585CrossRefPubMed
37.
Zurück zum Zitat Kanat-Pektas M, Ozat M, Gungor T, Dikici T, Yilmaz B, Mollamahmutoglu L (2011) Fertility outcome after conservative surgery for borderline ovarian tumors: a single center experience. Arch Gynecol Obstet 284(5):1253–1258CrossRefPubMed Kanat-Pektas M, Ozat M, Gungor T, Dikici T, Yilmaz B, Mollamahmutoglu L (2011) Fertility outcome after conservative surgery for borderline ovarian tumors: a single center experience. Arch Gynecol Obstet 284(5):1253–1258CrossRefPubMed
38.
Zurück zum Zitat Suh-Burgmann E (2006) Long-term outcomes following conservative surgery for borderline tumor of the ovary: a large population-based study. Gynecol Oncol 103(3):841–847CrossRefPubMed Suh-Burgmann E (2006) Long-term outcomes following conservative surgery for borderline tumor of the ovary: a large population-based study. Gynecol Oncol 103(3):841–847CrossRefPubMed
39.
Zurück zum Zitat Fortin A, Morice P, Thoury A, Camatte S, Dhainaut C, Madelenat P (2007) Impact of infertility drugs after treatment of borderline ovarian tumors: results of a retrospective multicenter study. Fertil Steril 87(3):591–596CrossRefPubMed Fortin A, Morice P, Thoury A, Camatte S, Dhainaut C, Madelenat P (2007) Impact of infertility drugs after treatment of borderline ovarian tumors: results of a retrospective multicenter study. Fertil Steril 87(3):591–596CrossRefPubMed
40.
Zurück zum Zitat Camatte S, Morice P, Thoury A et al (2004) Impact of surgical staging in patients with macroscopic “stage I” ovarian borderline tumours: analysis of a continuous series of 101 cases. Eur J Cancer 40(12):1842–1849CrossRefPubMed Camatte S, Morice P, Thoury A et al (2004) Impact of surgical staging in patients with macroscopic “stage I” ovarian borderline tumours: analysis of a continuous series of 101 cases. Eur J Cancer 40(12):1842–1849CrossRefPubMed
41.
Zurück zum Zitat Fauvet R, Boccara J, Dufournet C, David-Montefiore E, Poncelet C, Daraï E (2004) Restaging surgery for women with borderline ovarian tumors: results of a French multicenter study. Cancer 100(6):1145–1151CrossRefPubMed Fauvet R, Boccara J, Dufournet C, David-Montefiore E, Poncelet C, Daraï E (2004) Restaging surgery for women with borderline ovarian tumors: results of a French multicenter study. Cancer 100(6):1145–1151CrossRefPubMed
Metadaten
Titel
Utero-ovarian preservation and overall survival of young women with early-stage borderline ovarian tumors
verfasst von
Rachel S. Mandelbaum
Erin A. Blake
Hiroko Machida
Brendan H. Grubbs
Lynda D. Roman
Koji Matsuo
Publikationsdatum
28.03.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 6/2019
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05121-z

Weitere Artikel der Ausgabe 6/2019

Archives of Gynecology and Obstetrics 6/2019 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.