title: Ovarian preservation in young patients with stage I cervical adenocarcinoma: a surveillance, epidemiology, and end results study.
abstract: OBJECTIVE
  Although a large part of patients with cervical adenocarcinoma are young, oophorectomy is commonly performed in those who receive hysterectomy for fear of ovarian metastasis. The purpose of this study was to examine the safety of ovarian preservation in young women with cervical adenocarcinoma.
  
  
  METHODS
  Patients 45 years or younger with stage I cervical adenocarcinoma and adenosquamous carcinoma were identified in the Surveillance, Epidemiology, and End Results program (1988-2007). The characteristics of the patients with ovarian preservation were compared with those of the women with oophorectomy. Univariate Kaplan-Meier analysis and multivariate Cox proportional hazards model were used to explore the effects of ovarian preservation on survival.
  
  
  RESULTS
  The study sample consisted of 1639 women, including 1062 women (64.8%) who underwent oophorectomy and 577 women (35.2%) who had ovarian preservation at the time of hysterectomy. Younger age (P < 0.001), recent diagnosis (P < 0.001), low-grade (P < 0.001) and smaller tumor (P < 0.001), white population (P = 0.015), as well as less chance to undergo lymphadenectomy (P < 0.001) and adjuvant radiotherapy (P = 0.041) were associated with ovarian preservation. Ovarian preservation had no effect on either cancer-specific (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.50-1.61) or overall (HR, 0.81; 95% CI, 0.49-1.33) survival in the Cox proportional hazards model. When the patients without radiotherapy were separately analyzed, the effect on either cancer-specific (HR, 1.24; 95% CI, 0.44-3.54) or overall (HR, 0.77; 95% CI, 0.35-1.73) survival were not statistically significant.
  
  
  CONCLUSIONS
  Ovarian preservation may have oncological safety for young women with stage I cervical adenocarcinoma.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jiangtao
authors.initials: J
authors.lastname: Lyu
authors.forename: Tingting
authors.initials: T
authors.lastname: Sun
authors.forename: Xianjie
authors.initials: X
authors.lastname: Tan
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000328:Adult; D018196:Carcinoma, Adenosquamous / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000706:statistics & numerical data; D010052:Ovariectomy / Q000706:statistics & numerical data; D010053:Ovary / Q000601:surgery; D018426:SEER Program; D016019:Survival Analysis; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*