Safety of ovarian preservation in young patients with early-stage endometrial cancer: a retrospective study and meta-analysis

Ovarian involvement in endometrioid adenocarcinoma of uterus

“…Our findings support the concept of ovarian preservation in premenopausal women with corpus confined endometriod endometrial cancer in the absence of other poor prognostic factors. Previous studies have also reported an isolated microscopic ovarian involvement rate of approximately 1% and emphasized the safety and feasibility of ovarian preservation in premenopausal women undergoing surgery for endometrial cancer [2,3,7,8].…”

“…Adnexal metastases occur in 5% of clinical stage I endometrial cancers and typically present as enlarged masses or gross adnexal abnormalities that can be detected clinically or at time of surgery [1]. Previous studies have shown that less than one percent of cases with adnexal involvement present as microscopic metastases [2,3]. Synchronous endometrial and ovarian cancers have been reported to occur in 9-25% of premenopausal women with endometrial cancer [4,5].…”

ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up

“…Thus, to avoid the short-term and long-term consequences of surgical menopause, there is a rationale for ovarian preservation in young women. Several retrospective studies have recently provided evidence that ovarian preservation has no statistically significant impact on the overall survival (OS) of young patients with early-stage endometrial cancer 72. However, extreme care must be taken to rule out synchronous concomitant ovarian malignancy.…”

Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

“…Koskas et al compared the survival of patients with grade 1 endometrial adenocarcinoma according to the extent of surgery, with patients divided into three groups: those who underwent uterine preservation, those who underwent ovarian preservation, and those who underwent hysterectomy with bilateral salpingo-oophorectomy 24. Wright et al23 compared outcomes of bilateral salpingo-oophorectomy and ovarian preservation in women aged <45 years with stage 1 endometrial cancer between 1988 and 2004; and Sun et al19 and Richter et al25 retrospectively compared survival outcomes in patients aged <45 years with early stage endometrial cancer who underwent bilateral salpingo-oophorectomy or ovarian preservation.…”

“…In a multivariate Cox model, Koskas et al showed that ovarian and uterine preservation did not affect cancer-specific or overall survival in patients with grade 1 endometrial adenocarcinoma 24. Interestingly, although Sun et al showed that ovarian preservation had no statistically significant impact on overall survival,19 Richter et al found that bilateral salpingo-oophorectomy improved disease-free but not overall survival 25. Information about stage and grade was available for 4419 and 4259 patients, respectively 19 22–24.…”