RT  - European Journal of Gynaecological Oncology
ID  - 10.31083/j.ejgo4301006
T1  - The incidence and risk factors for ovarian metastasis and overall survival with ovarian preservation for early-stage adenocarcinoma of the cervix-A meta-analysis
A1  - Dongchen Wu
A1  - Lihua Zhang
A1  - Nitish Beharee
A1  - Li Yang
A1  - Yinan Wu
A1  - Yingchun Wang
A1  - Mengmeng Lv
A1  - Jin Lu
A1  - Jinhua Wang
K1  - Adenocarcinoma of cervix; Ovarian preservation; Ovarian metastasis; Risk factors
YR  - 2022
SP  - 56
AB  - <p><strong>Objective</strong>: To compare the incidence of ovarian metastasis (OM) in early stage adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the cervix, evaluate the overall survival with ovarian preservation and determine risk factors of OM for early stage AC. <strong>Data sources, methods of study selection</strong>: We searched the Cochranes database, Embase, and PubMed for publications to November 2020. The articles reporting the incidence, risk factors and overall survival of OM in AC were included. Articles that lacked sufficient data of the odds ratios (ORs) and 95% confidence intervals (CIs) were excluded. A fixed effects model was used to calculate OR and 95% CIs. Eggers test and Funnel plot were used to test the publication bias. Forest plots was used to present and synthesise results. <strong>Tabulation, integration and results</strong>: In the meta-analysis, the incidence of OM of AC was higher than that of SCC (OR 5.68, 95% CI 4.40–7.32, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 28.1%) in stage IA-IIB. The incidence of OM was 0% in stage IA, 2.72% in stage IB, 5.95% in stage IIA, and 12.86% in stage IIB AC. Ovarian preservation was not significantly associated with OS (OR 0.53, 95% CI 0.35–0.80, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 37.8%) in early stage of AC. We found seven risk factors for OM: deep stromal invasion (OR 8.80, 95% CI 3.20–24.23, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 0%), corpus uteri invasion (OR 6.29, 95% CI 3.36–11.77, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 21.8%), tumor size <inline-formula>&gt;<math><mo>&gt;</mo></math></inline-formula>4 cm (OR 3.78, 95% CI 1.86–7.69, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 30.5%), FIGO stage IIA (OR 3.67, 95% CI 1.98–6.81, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 0%), FIGO stage IIB (OR 4.31, 95% CI 2.74–6.77, <i>I</i><span style="font-size: 12px; vertical-align: super;">2 </span>= 0%), FIGO stage II (OR 3.99, 95% CI 2.49–6.41, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 0%) and lympho-vascular space invasion (OR 2.90, 95% CI 1.36–6.17, <i>I</i><span style="font-size: 12px; vertical-align: super;">2</span> = 0%). <strong>Conclusions</strong>: Ovarian preservation is only recommended in stage IA and stage IB AC without risk factors, but not reasonable for stage IIA and IIB AC. Both stage IIA and IIB are risk factors for OM in early stage AC.</p><p><br></p>