Risk factors in stage III epithelial ovarian cancer: previous sterilisation is an adverse independent prognostic indicator

Objectives: To determine whether past history of pelvic surgery is of progn ostic significance in stage III epithelial ovarian cancer. Methods: A retrospective review of 140 women with stage III epithelial ovar ian cancer. Results: Sixteen women had previously undergone pelvic surgery including ei ght sterilisations (6%), seven hysterectomies (5%) and one ovarian cystecto my (0.7%). Women with a past history of sterilisation were significantly yo unger (median age, 1 6 years) than women without a past history of sterilis ation (median age, 63 years), and also significantly younger than women wit h a past history of hysterectomy (median age, 58 years). In addition, the s terilisation procedure was performed at a significantly younger age than th e hysterectomy procedure (p=0.008). On multivariate analysis comparing prev ious pelvic surgery, previous malignancy, place of surgery, interval/second ary debulking, presence of concomitant tumour, performance of bowel surgery , histological grade, histological type, size of residual disease and age, all of the following were seen to be independent variables associated with outcome survival; previous sterilisation (p=0.0012), age (p=0.0074), histol ogical type (p=0.025), histological grade (p=0.0017) and size of residual d isease (p=0.0043). Conclusion: Past history of sterilisation appears to be an adverse independ ent prognostic indicator in women presenting with stage III epithelial ovar ian cancer. To have developed ovarian cancer despite the protective effects of a sterilisation procedure against environmental factors might possibly suggest a predisposition to ovarian cancer in these women. Further studies are indicated to confirm the present results.