Impact of Uterus-Preserving Surgery on Stage I Primary Mucinous Epithelial Ovarian Carcinoma: A Multi-Institutional Study With Propensity Score-Weighted Analysis

Int J Gynaecol Obstet. 2020 May 29. doi: 10.1002/ijgo.13244. Online ahead of print.


Objective: To investigate the clinical characteristics of women with Stage I primary mucinous epithelial ovarian carcinoma (mEOC) and evaluate the impact of uterus-preserving surgery (UPS) in terms of survival prognosis.

Methods: A regional multi-institutional retrospective study conducted between January 1986 and March 2017 by reviewing records of the Tokai Ovarian Tumor Study Group. Clinical and pathologic data and survival outcomes were assessed for women with Stage I primary mEOC. The baseline imbalance between women with and those without UPS was adjusted by an inverse probability of treatment weighting method using the propensity score (PS) of independent clinical variables.

Results: Among 4730 women with malignant ovarian tumors, 185 had Stage I primary mEOC and were included in the study. The mean age was 47.6 years (range 12-87 years), and 56 (30.3%) women underwent UPS. After PS-based adjustment, women in the UPS group did not have a poorer prognosis regarding overall survival (P=0.776) or recurrence-free survival (P=0.683). Even after age stratification, there was no statistical difference in survival outcomes between the UPS and non-UPS groups.

Conclusion: UPS was not associated with decreased survival and may be a treatment option for women with Stage I primary mEOC irrespective of age.

Keywords: Inverse probability of treatment weighting; Mucinous carcinoma; Oncofertility; Ovarian cancer; Prognosis; Propensity score; Uterus-preserving surgery.