Risk of contralateral ovarian cancer in patients undergoing conservative surgery for ovarian cancer

Abstract

Background: Among patients with ovarian cancer (OC), the risk of contralateral OC remains controversial and few studies have focused on the occurrence of contralateral OC after conservative surgery.

Methods: Basing on the Surveillance, Epidemiology, and End Results (SEER) database registered between 2000 and 2018, Logistic and Cox regressions were established to test the risk factors of contralateral OC. Kaplan-Meier mothed was used to calculate the cumulative risk curve for contralateral OC and compared using log-rank test. Furthermore, the frequency of contralateral OC and standardized incidence ratios (SIRs) were evaluated.

Results: 18807 patients were included, 69 patients developed contralateral OC. Logistic and Cox regressions showed patients diagnosed >50 years had lower risk of contralateral OC (Odds ratio [OR]:0.42, 95% confidence interval [CI]: 0.24-0.73; Hazard ratios [HR]:0.44, 95%CI:0.24-0.77). Patients with radical surgery had lower contralateral OC risk (OR:0.20, 95%CI: 0.11-0.36; HR: 0.17, 95%CI: 0.09-0.30). The SIR for contralateral OC was high in all patients (SIR: 2.37, 95%CI: 1.85-3.00) and highest if patients diagnosed <50 years with conservative surgery (SIR: 27.33, 95%CI: 19.86-36.69). However, the SIR for contralateral OC was low in patients diagnosed ≥50 years with radical surgery (SIR: 0.54, 95%CI: 0.26-1.00). No statistically significant SIRs were observed in patients diagnosed ≥50 years with conservative surgery and patients diagnosed <50 years with radical surgery.

Conclusions: Our study provided some information for clinicians to assess the risk of contralateral OC and suggested young patients should not undergo hysterectomy to prevent contralateral OC. Moreover, clinical surveillance cannot be relaxed.

Keywords: Contralateral ovarian cancer; Hysterectomy; Ovarian cancer; SEER; Surgery.