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KMID : 1137020180290050079
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Journal of Gynecologic Oncology
2018 Volume.29 No. 5 p.79 ~ p.79
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Teenage pregnancy complicated by primary invasive ovarian cancer: association for oncologic outcome
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Blake Erin A.
De Zoysa Madushka Y.
Morocco Elise B.
Kaiser Samantha B.
Kodama Michiko
Grubbs Brendan H.
Matsuo Koji
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Abstract
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Objective: To examine survival of teenage women with pregnancies complicated by primary ovarian cancer.
Methods: This is a secondary analysis of a previously organized systematic literature review of primary ovarian cancer diagnosed during pregnancy. Cases eligible for analysis were patients whose age at cancer diagnosis and survival outcome were known (n=201). Pregnancy and oncologic outcome were then examined based on patient age.
Results: These were comprised of 95 (47.3%) epithelial ovarian cancers (EOCs), 82 (40.8%) malignant germ cell tumors (MGCTs), and 24 (11.9%) sex-cord stromal tumors (SCSTs). Teenage pregnancy was seen in 21 (10%) cases, and was highest among the SCST group compared to the other cancer types (EOC, 1.1%; MGCT, 14.6%; and SCST, 29.2%, p<0.001). Live birth rates, neonatal weight, full term delivery rates, and Cesarean section rates were similar between the teenage group and the non-teenage group (all, p>0.05); however, teenage pregnancy was significantly associated with an increased risk of serious maternal/neonatal adverse events (50% vs. 22.7%, p=0.013). On univariable analysis, teenage pregnancy was significantly associated with decreased ovarian cancer-specific survival (5-year rate: age ≥30, 79.6%; age 20?29, 87.2%; and age <20, 41.6%; p<0.001). On multivariable analysis controlling for calendar year, cancer type, cancer stage, and gestational age at ovarian cancer diagnosis, teenage pregnancy remained an independent prognostic factor for decreased ovarian cancer-specific survival compared to women aged ≥30 (adjusted-hazard ratio=4.71; 95% confidence interval=1.17?18.9; p=0.029).
Conclusion: Teenage women with pregnancies complicated by primary ovarian cancer may be at increased risk of poor survival from ovarian cancer.
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KEYWORD
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Pregnancy, Teenage, Ovarian Neoplasms, Survival, Review
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