The Clinical Analysis Of Ovarian Metastasis And The Feasibility Of Ovarian Function Preservation In Cervical Adenocarcinoma

Background:As we know,in female patients,the morbidity of cervical cancer is the fourth in China,and cervical cancer is one of the female reproductive system tumour with the highest incidence and highest mortality.With the development of the society and the change of attitude towards sex,there is a trend that more and more young women suffer from cervical cancer.At the same time,the incidence of cervical adenocarcinoma is increasing gradually compared with cervical squamous carcinoma.It's widely believed that,the prognosis of adenocarcinoma is worse than squamous,and metastasis of ovarian of adenocarcinoma is more commonly seen compared with that of squamous.But few believe that in early stage,the prognosis of adenocarcinoma and squamous cell carcinoma of cervix is not obvious difference.So the traditional view of cervical adenocarcinoma resection is that bilateral attachment should be cut out at the same time.But for the past years,more and more young women demand the function of ovary,and we should take the feasibility of ovarian function preservation into account.Therefore,we hope that we can confirm the risk factors associated with ovarian metastasis in patients with cervical adenocarcinoma,and if the prognosis is good by investigating and analyzing clinical and follow-up data.Objective:To analyze the rate of ovarian metastasis and its risk factors in patients with cervical adenocarcinoma,and analysis the prognosis of patients who reserve ovaries,in order to confirm the feasibility of ovarian function preservation in cervical adenocarcinoma.Methods:The clinical and follow-up data of patients with cervical adenocarcinoma in Shandong University Qilu Hospital from January 2005 to December 2016 were collected.There are 233 patients included 44 patients reserved ovary and 189 patients ovariectomized.Then divide patients whose ovaries were cut off into two groups by ovarian metastatic or not,and compare the two groups to analyze the risk factors.On the other hand,analyze the survival curve of patients ovariectomized and those reserved ovary,in order to confirm the feasibility of ovarian function preservation.Result:? The rate of ovarian metastasis of adenocarcinoma of cervix is 3.43%.? The average age is 45.0±9.92 years old,and the average age of the patients with ovarian metastasis is 45.5±7.9 years old while that of patients without ovarian metastasis is 45.0±10.0 years old.So age is not associated with ovarian metastasis.? The single factor analysis indicated that clinical stages,degree of histologic differentiation,lymph-vascular space invasion(LSVI),lymph node,interstitial infiltration depth,parametrial involvement,invasion of uterine body,metastasis of tubal and vaginal residue were associated with ovarian metastasis.? Multivariate analysis shows high risk factor included poorly differentiated,LSVI(+),the depth of interstitial infiltration>1/2,parametrial involvement(+)and vaginal residue(+).? Log-rank survival test shows that the survival curve of patients reserved ovary is undifferentiated from that of patients ovariectomized.Conclusions:Ovarian metastasis rate of cervical adenocarcinoma is low.Patients with tumour poorly differentiated,negative LSVI,<1/2 cervical stromal invasion,negative parametrial involvement and negative vaginal residue can consider preservation of ovary;but these findings still need to be further confirmed by large randomized controlled trials.