Teenage pregnancy complicated by primary invasive ovarian cancer: association for oncologic outcome.
- Author:
Erin A BLAKE
1
;
Madushka Y DE ZOYSA
;
Elise B MOROCCO
;
Samantha B KAISER
;
Michiko KODAMA
;
Brendan H GRUBBS
;
Koji MATSUO
Author Information
- Publication Type:Original Article
- Keywords: Pregnancy; Teenage; Ovarian Neoplasms; Survival; Review
- MeSH: Cesarean Section; Diagnosis; Female; Gestational Age; Humans; Live Birth; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms*; Pregnancy; Pregnancy in Adolescence*
- From:Journal of Gynecologic Oncology 2018;29(5):e79-
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
