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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
  1. Xiao-Bing Jiao, MD,
  2. Jun Hu, MD and
  3. Li-Rong Zhu, MD
  1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
  1. Address correspondence and reprint requests to: Li-Rong Zhu, MD, Department of Obstetrics and Gynecology, Peking University First Hospital, No.1, Xi’anmen Street, Beijing, 100034, China. E-mail: lirongzhu16{at}hotmail.com.

Abstract

Objective The aim of this study was to compare the incidence of ovarian metastasis (OM) in adenocarcinoma (ADC) and squamous cell carcinoma (SCC) in early-stage cervical cancer and evaluate the safety of ovarian preservation in early-stage ADC.

Methods To perform a meta-analysis to compare the incidence of OM between early-stage ADC and SCC, we searched PubMed, EMBASE, and Cochrane for observational studies that compared it with pathological evidence after radical hysterectomy and oophorectomy. Odds ratios with 95% confidence intervals were calculated with a fixed effects model. We also found a few articles evaluating the oncological prognosis of patients with ovarian preservation to perform a systematic review.

Results A total of 5 studies were included in the meta-analyses. The incidence of OM of patients with early-stage ADC and SCC were 2% and 0.4%, respectively (odds ratio, 5.27; 95% confidence interval, 2.14–13.45). In 1427 patients with ADC or SCC of the cervix FIGO stage (CIS-IIA) who underwent hysterectomy, no ovarian recurrences were observed after unilateral or bilateral ovarian preservation in ADC patients in the follow-up (30–68 months); however, 15 patients with SCC developed pelvic recurrence.

Conclusions 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.

  • Cervical cancer
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Ovarian preservation
  • Ovarian metastasis

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Footnotes

  • The authors declare no conflicts of interest.

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