Ovarian involvement in endometrioid adenocarcinoma of uterus

Lin, Ken Y.; Miller, David S.; Bailey, Alan; Andrews, Sajan; Kehoe, Siobhan M.; Richardson, Debra L.; Lea, Jayanthi

doi:10.1016/j.ygyno.2015.07.012

Cited by 35 publications

(20 citation statements)

References 15 publications

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“…28 Two descriptive studies evaluating the safety of ovarian preservation in EC patients have noted that young patients of early-stage and low tumor grade, with myometrial invasion 50% or less, are proper candidates for ovarian preservation. 24,29 The feature of our data is consistent with these descriptive studies. The included patients were mostly younger than the age of 45, stage I, and with tumor grade I or II.…”

Section: Discussionsupporting

confidence: 92%

“…The rate of ovarian involvement in early-stage EC is approximately 5%, but most of those patients were with abnormal ovaries that could be detected either by preoperative imaging or surgical exploration, whereas the rate of microscopic lesion is less than 1%. 14,23,24 Theoretically, the probability of leaving suspicious ovaries during a surgical management is extremely low. Third, the risk of future primary cancer could be elevated in young women with EC because there may be underlying hereditary cause in those patients, for example, Lynch syndrome and BRCA mutation, which are most related.…”

Section: Discussionmentioning

confidence: 99%

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Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

Gu¹,

Li²,

Gu³

et al. 2016

Int J Gynecol Cancer

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

Gu¹,

Li²,

Gu³

et al. 2016

Int J Gynecol Cancer

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“…However, occasionally these patients present with occult ovarian malignant involvement, as evident from postoperative detailed pathological inspection. In our analysis, ovarian malignant involvement occurred in 4.5% patients with clinical stage I endometrioid endometrial carcinoma, in keeping with Lin et al [16] who reported ovarian involvement in 5% of their patient group. The ratio of ovarian malignant involvement in low risk patients was 1.04% while patients in the sub-high risk group positive for at least one risk factor showed higher ovarian involvement (6.6%).…”

Section: Discussionsupporting

confidence: 92%

Preoperative predictive factor analysis of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma

Chen

Feng

Wang

et al. 2020

Preprint

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Background Earlier literature suggests that ovarian preservation in young premenopausal clinical stage I endometrioid endometrial carcinoma patients does not negatively impact prognosis and is a more suitable choice for management of the disease. The main purpose of this study was to clarify the incidence of ovarian malignant involvement in premenopausal clinical stage I endometrioid endometrial carcinoma and further identify potential preoperative predictive factors of ovarian malignant involvement. Methods Premenopausal patients (≤50 years) with clinical stage I endometrioid endometrial carcinoma subjected to total hysterectomy and bilateral salpingo-oophorectomy with or without pelvic and/or para-aortic lymph node dissection at Women’s Hospital, Zhejiang University School of Medicine between 2002 and 2016 were enrolled for study. Patients were excluded in cases of gross extra pelvic disease on examination or imaging and family history of colon or gastrointestinal carcinoma. The included patient population was examined for incidence of ovarian malignant involvement and potential preoperative clinical predictive factors.Results A total of 511 premenopausal (age≤50 years) patients diagnosed with clinical stage I endometrioid endometrial carcinoma were enrolled for the study. Ovarian malignant involvements were detected in 23 of the patients (4.5%). Kaplan-Meier analysis showed poorer prognoses of patients with ovarian malignant involvement than those without ovarian involvement. Univariate and multivariate logistic analysis validated preoperative imaging of myometrial invasion depth, the gross appearance of the ovaries, and preoperative serum carbohydrate antigen 125 (CA125) level as independent risk predictors of postoperative ovarian malignant involvement. Receiver operating characteristic (ROC) curves was individually generated for preoperative myometrial invasion depth, the gross appearance of the ovaries, and serum CA125 level as well as a combination of the three factors. The area under curve (AUC) was 0.858 (95% confidence interval [CI], 0.757–0.960) for the combined three factors.Conclusions The incidence of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma was relatively minimal. Preoperative imaging of myometrial invasion depth, the gross appearance of the ovaries, and serum CA125 level were independent risk predictors of ovarian malignant involvement. These findings may facilitate preoperative counseling of patients and informed clinical decision-making on ovarian preservation in these patients.

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“…Lee et al found that among the 206 patients without any evidence of intraoperative extrauterine disease, the coexisting ovarian malignancy rate was 0.97%, and zero for those under age of 45 [ 7 ]. Ken et al also reported that ovarian involvement occurred in 5% of patients with clinical stage I EC, and microscopic ovarian involvement without grossly visible lesions only occurred in 0.8% of the patients [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Ovarian preservation improves overall survival in young patients with early-stage endometrial cancer

Jia

Zhang

2017

Oncotarget

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We searched Medline, Embase, Cochrane library, the Chinese Biomedicine Literature Database, the Chinese Scientific Journal Full-text Database, the Chinese Journal Full-text Database, and the Wanfang Database to collect observational studies on the effects of ovary-saving surgery in comparison to bilateral salpingo-oophorectomy (BSO) in young patients with early-stage endometrial cancer (EC). The literature search included studies up to March 2017, and 10 retrospective cohort studies met our selection criteria. Random and fixed effect models revealed that ovarian preservation (OP) was associated with better overall survival (OS) (hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.57–0.99, P = 0.044), and was not associated with reduced recurrence-free survival (RFS) in pre-menopausal patients with early-stage endometrial cancer (HR 1.22, 95% CI 0.32–4.72, P = 0.648; risk ratio [RR] 1.11, 95% CI 0.59–2.10, P = 0.745). Preservation of the ovaries appears to be a safe option with significant benefit for this low risk population after a thorough preoperative evaluation and extensive intraoperative exploration.

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Ovarian involvement in endometrioid adenocarcinoma of uterus

Cited by 35 publications

References 15 publications

Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

Preoperative predictive factor analysis of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma

Ovarian preservation improves overall survival in young patients with early-stage endometrial cancer

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