Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer

Matsuo, Koji; Cripe, J.C.; Kurnit, Katherine C.; Kaneda, Masanori; Garneau, Audrey; Glaser, Gretchen; Nizam, Aaron; Schillinger, Rachel M.; Kuznicki, Michelle; Yabuno, Akira; Yanai, Shiori; Garofalo, Denise M.; Suzuki, Jun; Laurent, J.D. St.; Yen, Ting Tai; Liu, Annie Y.; Shida, Masako; Kakuda, Mamoru; Oishi, Tsutomu; Nishio, Yukihiro; Marcus, Jenna; Adachi, Sosuke; Kurokawa, Tetsuji; Ross, Malcolm S.; Horowitz, Max; Johnson, Marian S.; Kim, Min K.; Melamed, Alexander; Machado, Karime Kalil; Yoshihara, Kosuke; Yoshida, Yoshio; Enomoto, Takayuki; Ushijima, Kimio; Satoh, Shinya; Ueda, Yutaka; Mikami, Mikio; Rimel, B.J.; Stone, Rebecca L.; Growdon, Whitfield B.; Okamoto, Aikou; Guntupalli, Saketh R.; Shahzad, Mian M.K.; Im, Dwight D.; Frimer, Marina; Gostout, Bobbie S.; Ueland, Frederick R.; Nagao, Shoji; Soliman, Pamela T.; Thaker, Premal H.; Wright, Jason D.; Roman, Lynda D.

doi:10.1016/j.ygyno.2019.08.007

Cited by 17 publications

(21 citation statements)

References 35 publications

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“…In the present study, which included premenopausal patient population at low risk for recurrence, 1.9% (1/52) of patients had microscopic fallopian tube involvement and none had ovarian involvement. The results of the present study are in line with the most recently published multicenter, international paper with large numbers on the topic by Matsuo et al 12 wherein only one out of 113 patients had recurrence in the preserved ovary and none developed a metachronous ovarian cancer. In acknowledging the low incidence of ovarian recurrence/metachronous cancer, it is hoped to provide an argument supporting ovarian preservation and to incite future research opportunities in this select patient population with early stage low‐risk endometrioid endometrial cancer.…”

Section: Discussionsupporting

confidence: 92%

“…Several other studies 12,24,25 have been published evaluating the outcome of patients who underwent ovarian preservation during surgical staging for endometrial cancer. In 2009, Wright et al 2 published a study that evaluated women aged 45 years or younger with stage I endometrioid endometrial cancer recorded from 1988 to 2004 in the Surveillance, Epidemiology and End Results (SEER) Database.…”

Section: Discussionmentioning

confidence: 99%

“…They found that there was no difference in either recurrence‐free or overall survival between the patients whose ovaries were removed versus preserved. Matsuo et al 12 most recently published a multicenter and multinational study evaluating patterns of recurrence, survival, and presence of metachronous secondary malignancy in patients aged under 50 years with stage 1 grade 1–2 endometrioid endometrial cancer in both Japan and the USA, with respective cohorts of 495 and 1196 patients 12 . Their data demonstrated variability among risks of recurrence and secondary ovarian malignancy but no difference in disease‐free survival with ovarian preservation in the US cohort when data were adjusted for age.…”

Section: Discussionmentioning

confidence: 99%

“…Jia et al 8 published a study in 2017 evaluating patients with early stage endometrial cancer and found that ovarian preservation was associated with better overall survival and was not associated with reduced recurrence‐free survival. There have been several other studies published supporting the conclusion that ovarian preservation in young patients with early stage endometrioid endometrial cancer does not decrease overall survival 2,9–13 …”

Section: Introductionmentioning

confidence: 98%

“…There have been several other studies published supporting the conclusion that ovarian preservation in young patients with early stage endometrioid endometrial cancer does not decrease overall survival. 2,[9][10][11][12][13] With the hopes of eventually changing the recommendations of traditional surgical staging procedures, the aim of the present study was to determine the incidence of microscopic adnexal involvement of International Federation of Gynecology and Obstetrics (FIGO) grade 1 endometrioid endometrial cancer in pre and peri-menopausal women with presumed early stage disease. The study hypothesis is that there is a very low incidence of microscopic adnexal metastasis present in this population.…”

Section: Introductionmentioning

confidence: 99%

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Risk‐stratifying clinicopathologic criteria for ovarian preservation in premenopausal women with early stage low‐risk endometrial cancer

Khadraoui

Tierney

Chung

et al. 2020

Intl J Gynecology & Obste

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Objective: To establish the rate of occult ovarian micro-metastases in early stage disease and to provide an eligibility framework for providers to consider ovarian preservation in a patient population with presumed early stage disease. Methods: A retrospective review from January 2005 to December 2010 identified women with presumed early stage endometrial cancer from a single institutional database. Inclusion criteria included: (1) FIGO grade 1 endometrioid endometrial cancer on endometrial biopsy; or (2) the same pathology as (1) on frozen section specimen with less than 50% myometrial biopsy; and (3) no evidence of metastatic disease on preoperative imaging or visible metastatic disease in the peritoneal cavity. Results: Of the 52 patients, 86.5% were diagnosed with stage IA and 11.5% were diagnosed with stage II disease. One patient (1.9%) had microscopic adnexal involvement in a fallopian tube, which upstaged her to stage IIA disease. None of the patients had ovarian involvement. Conclusion: Preservation of the ovaries appears to be a safe and viable option for premenopausal women who are diagnosed with presumed early stage endometrioid endometrial cancer. It is believed that ovarian preservation in this select population will provide them with significant health benefits and improve their quality of life.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%