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Arch Gynecol Obstet. 2019 Mar 28. doi: 10.1007/s00404-019-05121-z. [Epub ahead of print]

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

Author information

1
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA.
2
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
3
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
4
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA. koji.matsuo@med.usc.edu.
5
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. koji.matsuo@med.usc.edu.

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.

KEYWORDS:

Borderline ovarian tumor; Fertility-sparing surgery; Hysterectomy; Ovarian preservation; Survival

PMID:
30923905
DOI:
10.1007/s00404-019-05121-z

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