Clinical Characteristics of Uterine Metastasis in Epithelial Ovarian Cancer
Keywords:
Carcinoma, Ovarian Epithelial, Neoplasm Metas, Fertility-sparing SurgeryAbstract
Objective: Epithelial malignancies of the ovary spread directly and easily to the serous coat of uterus. However, the occurrence of invasion and metastasis within the parenchyma of the uterus is unknown. The rate of metastasis and its associated clinical features provide objective data to support surgery for uterus-preserving ovarian cancer.
Methods: The data of patients with epithelial ovarian cancer (OC) who underwent hysterectomy from January 1, 2017, to March 31, 2022, were collected retrospectively. The study analyzed the distribution of uterine metastasis and identified risk factors related to clinical characteristics.
Results: A total of 393 patients were included, and the uterine metastasis rate confirmed by pathology was 34.35%, with 26.72% of metastasis of the serous coat of the uterus, and 5.85% of myometrial metastasis and 1.78% of endometrial metastasis. For stage II patients, there were only 12.5% uterine metastases, and only 4.8% had parenchymal metastases to the uterus. The occurrence of metastasis is negatively related to low CA125 and HE4 values, unilateral ovarian lesion, no involvement of fallopian tubes, non-grade 3 (G3), non-serous, without pelvic metastasis, and the presence of endometriosis. These factors were found to be protective against uterine metastasis. Among them, bilateral ovarian lesion, fallopian tubes involvement and pelvic metastasis are the main independent risk factors for uterine metastasis of ovarian cancer.
Conclusion: The incidence of uterine metastasis from ovarian cancer was 34.35%. For stage II patients, there were only 4.8% had parenchymal metastases to the uterus. The presence of unilateral ovarian lesions and the absence of involvement of the fallopian tubes and other pelvic organs were independent protective factors. This offers a new possibility to preserve fertility in patients with stage II ovarian cancer.
Keywords: Carcinoma, Ovarian Epithelial; Neoplasm Metas; Fertility-sparing Surgery
