Anatomoclinical study of ovarian cancers in patients with history of hysterectomy for benign pathology

• Published in: Journal de gynecologie, obstetrique et biologie de la reproduction Vol. 45; no. 6; p. 571
• Main Authors: Cornou, C, Philippe, A C, Le Bouedec, G, Dauplat, M M, Dauplat, J, Pomel, C
• Format: Journal Article
• Language: French
• Published: France 01.06.2016
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Hysterectomy - statistics & numerical data; Lymph Node Excision - statistics & numerical data; Middle Aged; Ovarian Neoplasms - epidemiology; Retrospective Studies; Lymphadenectomy; Peritoneal carcinomatosis; Carcinose péritonéale; Cancer de l’ovaire; Hystérectomie; Hysterectomy; Lymphadénectomie; Ovarian cancer
• ISSN: 1773-0430
• DOI: 10.1016/j.jgyn.2015.06.020

To establish the various anatomoclinical characteristics of ovarian cancer in patients with a history of hysterectomy for benign disease. This is a comparative, retrospective, monocentric and descriptive study, carried out at the Centre of Jean-Perrin in patients with ovarian cancer between 2005 and 2014 and with a history of hysterectomy for benign disease. Each patient was paired with a non-hysterectomy patient with ovarian cancer. The two populations were matched 1 to 5, based on their age at diagnosis and their FIGO stage. During the period of the study, 249 patients were operated for de novo ovarian neoplasia, 43 patients had a history of hysterectomy (group 1) and 206 remaining patients represented the control group (group 2). There was no difference in overall survival and disease-free survival between the two subpopulations of patients (P=0.59 and P=0.38). On CT-scan assessment, the lymph node involvement risk was greater than 2.6 in the group of patients with hysterectomy (P=0.00038). Peritoneal Cancer Index scores of the two subgroups of populations were comparable, there were an average of 13.65 for group 1 versus 12.31 for group 2 (P=0.28). The rate of rectosigmoid resection was higher in group 1: 48.6% versus 32.9% in group 2 without any significant difference (P=0.07). Hundred and thirty-three patients undergone lumbar aortic lymphadenectomy, with node involvement found in 83% of patients in the hysterectomy group and 51% of patients in the control group (P=0.0053). Indication of lumbar aortic lymphadenectomy should be taken in better consideration in patients with history of inter-adnexial hysterectomy. These data must be thoroughly assessed with a prospective multicenter comparative study.