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Factors affecting the long-term prognosis of patients in the AYA generation with epithelial ovarian cancer : A multicenter propensity score matching analysis

Miyamoto, Emiri ; Yoshihara, Masato ; Iyoshi, Shohei ; Mogi, Kazumasa ; Uno, Kaname LU orcid ; Fujimoto, Hiroki ; Kitami, Kazuhisa ; Yoshikawa, Nobuhisa and Kajiyama, Hiroaki (2024) In International Journal of Gynecology and Obstetrics
Abstract

Objective: Ovarian carcinoma (OvCa) is more common in the elderly, but also affects the adolescent and young adult (AYA) generation, which refers to those aged 15–39 years. Although the characteristics of OvCa may differ between AYAs and non-AYAs, limited information is currently available on differences in prognostic factors. Therefore, we herein investigated prognostic factors for and the prognosis of OvCa in AYAs. We also examined the prognostic impact of fertility-sparing surgery in a subgroup analysis. Methods: We retrospectively collected data on 4897 patients with OvCa from the databases of multiple institutions and ultimately included 1161 patients with epithelial ovarian cancer (EOC). We performed a survival analysis to compare... (More)

Objective: Ovarian carcinoma (OvCa) is more common in the elderly, but also affects the adolescent and young adult (AYA) generation, which refers to those aged 15–39 years. Although the characteristics of OvCa may differ between AYAs and non-AYAs, limited information is currently available on differences in prognostic factors. Therefore, we herein investigated prognostic factors for and the prognosis of OvCa in AYAs. We also examined the prognostic impact of fertility-sparing surgery in a subgroup analysis. Methods: We retrospectively collected data on 4897 patients with OvCa from the databases of multiple institutions and ultimately included 1161 patients with epithelial ovarian cancer (EOC). We performed a survival analysis to compare AYAs and non-AYAs with backgrounds that conformed to those of AYAs using the propensity score (PS) matching method. A Cox regression analysis was also conducted to evaluate each predictor of recurrence-free survival (RFS) and overall survival (OS) in the original population. As a subgroup analysis, a multivariate analysis stratified by the AYA and non-AYA generations was performed. Results: In total, 119 AYA patients were included in this study. After PS adjustments, no significant differences were observed in RFS or OS between AYAs and non-AYAs. Prognostic factors differed between AYAs and non-AYAs, particularly in histology and cytology. A multivariate analysis stratified by the AYA and non-AYA generations described that uterine-preserving surgery (UPS) did not have a significant impact on the prognosis of AYAs or non-AYAs. In cases with recurrence, no significant differences were observed in RFS and recurrent sites in the two groups. Conclusion: Characteristic prognostic factors for EOC in AYAs were identified. The present results indicate the limited prognostic impact of UPS for EOC in AYAs.

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organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
AYA generation, fertility-sparing surgery, ovarian carcinoma, prognosis, propensity score
in
International Journal of Gynecology and Obstetrics
publisher
Wiley-Blackwell
external identifiers
  • pmid:38607295
  • scopus:85190506451
ISSN
0020-7292
DOI
10.1002/ijgo.15479
language
English
LU publication?
yes
id
495b95a0-fc41-4c17-8614-85229c1237ac
date added to LUP
2024-04-29 09:08:33
date last changed
2024-05-13 10:27:06
@article{495b95a0-fc41-4c17-8614-85229c1237ac,
  abstract     = {{<p>Objective: Ovarian carcinoma (OvCa) is more common in the elderly, but also affects the adolescent and young adult (AYA) generation, which refers to those aged 15–39 years. Although the characteristics of OvCa may differ between AYAs and non-AYAs, limited information is currently available on differences in prognostic factors. Therefore, we herein investigated prognostic factors for and the prognosis of OvCa in AYAs. We also examined the prognostic impact of fertility-sparing surgery in a subgroup analysis. Methods: We retrospectively collected data on 4897 patients with OvCa from the databases of multiple institutions and ultimately included 1161 patients with epithelial ovarian cancer (EOC). We performed a survival analysis to compare AYAs and non-AYAs with backgrounds that conformed to those of AYAs using the propensity score (PS) matching method. A Cox regression analysis was also conducted to evaluate each predictor of recurrence-free survival (RFS) and overall survival (OS) in the original population. As a subgroup analysis, a multivariate analysis stratified by the AYA and non-AYA generations was performed. Results: In total, 119 AYA patients were included in this study. After PS adjustments, no significant differences were observed in RFS or OS between AYAs and non-AYAs. Prognostic factors differed between AYAs and non-AYAs, particularly in histology and cytology. A multivariate analysis stratified by the AYA and non-AYA generations described that uterine-preserving surgery (UPS) did not have a significant impact on the prognosis of AYAs or non-AYAs. In cases with recurrence, no significant differences were observed in RFS and recurrent sites in the two groups. Conclusion: Characteristic prognostic factors for EOC in AYAs were identified. The present results indicate the limited prognostic impact of UPS for EOC in AYAs.</p>}},
  author       = {{Miyamoto, Emiri and Yoshihara, Masato and Iyoshi, Shohei and Mogi, Kazumasa and Uno, Kaname and Fujimoto, Hiroki and Kitami, Kazuhisa and Yoshikawa, Nobuhisa and Kajiyama, Hiroaki}},
  issn         = {{0020-7292}},
  keywords     = {{AYA generation; fertility-sparing surgery; ovarian carcinoma; prognosis; propensity score}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{International Journal of Gynecology and Obstetrics}},
  title        = {{Factors affecting the long-term prognosis of patients in the AYA generation with epithelial ovarian cancer : A multicenter propensity score matching analysis}},
  url          = {{http://dx.doi.org/10.1002/ijgo.15479}},
  doi          = {{10.1002/ijgo.15479}},
  year         = {{2024}},
}