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

Emiri Miyamoto; Masato Yoshihara; Shohei Iyoshi; Kazumasa Mogi; Kaname Uno; Hiroki Fujimoto; Kazuhisa Kitami; Nobuhisa Yoshikawa; Hiroaki Kajiyama

doi:10.1002/ijgo.15479

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

Int J Gynaecol Obstet. 2024 Apr 12. doi: 10.1002/ijgo.15479. Online ahead of print.

Authors

Emiri Miyamoto¹, Masato Yoshihara¹, Shohei Iyoshi¹, Kazumasa Mogi¹, Kaname Uno^{1

2}, Hiroki Fujimoto^{1

3}, Kazuhisa Kitami^{1

4}, Nobuhisa Yoshikawa¹, Hiroaki Kajiyama¹

Affiliations

¹ Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
² Division of Clinical Genetics, Department of Laboratory Medicine, Lund University Graduate School of Medicine, Lund, Sweden.
³ Discipline of Obstetrics and Gynecology, Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
⁴ Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan.

PMID: 38607295
DOI: 10.1002/ijgo.15479

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 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.

Keywords: AYA generation; fertility‐sparing surgery; ovarian carcinoma; prognosis; propensity score.