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Benoit L, Pajot C, Koual M, Nguyen-Xuan HT, Bentivegna E, Bats AS, Azaïs H. Could uterine conservation be an option in presumed early-stage epithelial ovarian cancer? Arch Gynecol Obstet 2023; 308:953-960. [PMID: 37031304 DOI: 10.1007/s00404-023-07016-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/18/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE In early-stage epithelial ovarian cancer (EOC), patients usually undergo a hysterectomy. However, in fertility sparing surgery (FSS), carefully selected patients could conserve their uterus. The aim of our study was to evaluate the incidence and epidemiologic characteristics associated with uterine involvement in patients with early-stage EOC, outside of FSS. METHODS We conducted a retrospective, monocentric, study from 2003 to 2019 and included all patients with a presumed early-stage EOC (FIGO I) who underwent a hysterectomy. The incidence of uterine involvement, predictive factors of uterine involvement, and the impact of uterine involvement on survival (recurrence-free survival and overall survival) were analyzed. RESULTS Eighty-five patients had an early-stage EOC. Of these, six had an uterine involvement (7%). The populations of patients with or without uterine involvement did not differ except for CA 125 at diagnosis (136 ± 138 versus 356 ± 723, p = 0.04, respectively). No patient or tumor characteristics were predictive of uterine involvement. Uterine involvement was not associated with recurrence-free survival (HR = 1.26, IC95% 0.36-4.4, p = 0.72) or overall survival (HR = 0.7, IC95% 0.1-6.1, p = 0.77). CONCLUSION Due to the small size of our sample, no conclusion can be drawn, yet it could be hypothesized that, for selected patients, a systematic hysterectomy could be discussed, notably in restaging surgery.
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Affiliation(s)
- Louise Benoit
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France.
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France.
- INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints Pères, Paris, France.
- Gynecologic and Breast Oncologic Surgery Department, European Georges Pompidou Hospital, 20 Rue Leblanc, 75015, Paris, France.
| | - Camille Pajot
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
| | - Meriem Koual
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France
- INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints Pères, Paris, France
| | - Huyen-Thu Nguyen-Xuan
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
| | - Enrica Bentivegna
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
| | - Anne-Sophie Bats
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Equipe labellisée Ligue Nationale contre le cancer, Paris, France
| | - Henri Azaïs
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Equipe labellisée Ligue Nationale contre le cancer, Paris, France
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Schwab R, Anic K, Hasenburg A. Cancer and Pregnancy: A Comprehensive Review. Cancers (Basel) 2021; 13:3048. [PMID: 34207252 PMCID: PMC8234287 DOI: 10.3390/cancers13123048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 01/11/2023] Open
Abstract
Cancer diagnosis and treatment in pregnant women is a challenging situation. A multidisciplinary network of specialists is required to guide both, the expecting mother and the unborn child through the diagnostic workup and the cytotoxic therapy, by balancing the respective risks and benefits. Tumor entity, stage, biology and gestational week at diagnosis determine the appropriate approach. As premature delivery emerged as one of the main risk factors for adverse long-term outcome of the progeny, it should be avoided, if reasonable from the oncological perspective. This article offers a comprehensive review with respect to the various aspects of cancer in pregnancy.
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Affiliation(s)
- Roxana Schwab
- Department of Obstetrics and Women’s Health, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (K.A.); (A.H.)
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