A study of risk factors for ovarian metastases in stage Ib-IIIb cervical carcinoma and analysis of ovarian function after a transposition.
OBJECTIVE
The objective of the present study was to examine the incidence and risk factors of ovarian metastases in cervical carcinoma. The function of transposed ovaries was also studied.


METHODS
In order to analyze the risk factors of ovarian metastases, 255 slides of pathological specimens were reassessed by multivariate logistic regression analysis. Fifty-six patients were studied prospectively on the basis of the function of transposed ovaries. Basal body temperature and serum hormone levels were analyzed.


RESULTS
Ovarian metastasis was identified in 2 of 485 (0.4%) patients with squamous cell carcinoma and in 12 of 146 (8.2%) patients with nonsquamous tumors of the cervix. Histologic type (P = 0.0014) and blood vessel invasion (P = 0.0433) were significant independent risk factors for ovarian metastases, as revealed by multivariate logistic regression analysis. Cumulative survival curves of preserved ovaries showed a significant (P < 0.005) decline in the group with postoperative radiotherapy.


CONCLUSIONS
Preservation of ovarian function should be pursued in patients with squamous cell carcinoma of the cervix, provided that the patient has no other risk factor (blood vessel invasion) for ovarian metastases. Moreover, sufficient attention should be paid to the proper handling of ovarian blood vessels during surgery, in order to shield and protect them from exposure to scattered radiation administered during postoperative radiotherapy.
Yamamoto
R
R
Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638, Japan.
Okamoto
K
K
Yukiharu
T
T
Kaneuchi
M
M
Negishi
H
H
Sakuragi
N
N
Fujimoto
S
S
D000230:Adenocarcinoma / Q000503:physiopathology / Q000556:secondary / Q000601:surgery; D000328:Adult; D018196:Carcinoma, Adenosquamous / Q000503:physiopathology / Q000556:secondary / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D016015:Logistic Models; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000556:secondary*; D010053:Ovary / Q000503:physiopathology* / Q000601:surgery; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery