Feasibility of ovarian preservation in patients with early stage endometrial carcinoma

Ovarian preservation during the surgical treatment of early stage endometrial cancer: A nation-wide study conducted by the Korean Gynecologic Oncology Group

“…In this regard, we have previously reported data which showed that the risk of a coexisting malignancy is negligible in patients with minimal preoperative risk factors and no intraoperative evidence of advanced disease [8]. The present study expands upon our previous data by adding follow-up results of a significant number of patients who have undergone ovary-preserving surgeries to determine whether ovarian preservation is feasible in younger endometrial cancer patients.…”

“…Gistch et al reported the highest ovarian synchronous malignancy rate (29%), but the total number of patients was only 17, and they noted occult metastasis in grossly normal looking ovaries in one case only (1/17, 5.9%) [12]. In addition, the crude coexisting malignancy rate in the Korean population is approximately 7% in a previous report and is not low compared with those in other countries [8]. The question that should be asked is whether saving a normal looking ovary in patients with early stage disease without predictable risk factors incurs unacceptable additional risk.…”

“…Nevertheless, we believe that this nation-wide study and our previous study question the validity of bilateral salpingo-oophorectomy as a standard surgical therapy for endometrial cancer in patients with disease limited to the uterus [8]. In this regard, we propose possible candidates of ovarian preservation in the surgical treatment of patients with endometrial cancer as shown in Table 5.…”

“…However, these reports failed to mention whether other evidence of extrauterine disease was present. Last year (2007), we reviewed 260 surgically treated endometrial cancer patients and found a 7.3% coexisting malignancy rate, but this was only 0.97% in patients without any evidence of intraoperative gross extrauterine disease [8]. Another separate study analyzing 160 cases conducted by a single institute in Korea also showed that staging surgery with or without BSO does not affect disease recurrence and overall survival in clinical stage I-II endometrial cancer patients [16].…”

Premenopausal early-stage endometrial carcinoma patients with low CA-125 levels and low tumor grade may undergo ovary-saving surgery

“…Several reports have estimated that the incidence of coexisting ovarian malignancy (primary or metastatic) is 5-29% of patients with endometrial carcinoma. [3][4][5] The prognosis of primary or metastatic ovarian cancers is quite different. Some investigators reported that synchronous early-stage ovarian cancers coexisting with endometrial cancers showed a favorable prognosis.…”