The Survival Effect of Ovary Preservation in Early Stage Endometrial Cancer: A Single Institution Retrospective Analysis

Abstract

Purpose: We investigated the effect of ovary preserving surgery in early International Federation of Obstetrics and Gynecology (FIGO) stage endometrial cancer patients.Methods: Medical records were retrospectively reviewed for 539 patients who were diagnosed with early stage endometrial cancer between Jan 2006 and Dec 2017. Patients were categorized into ovary preservation and ovary removal groups. Demographics, recurrence free survival (RFS), and five-year overall survival (OS) rate were compared, and the clinical factors affecting survival were evaluated by univariate and multivariate analysis.Results: The median follow-up period was 85 months (range, 6-142 months), and the median age was 52.7 years. The mean age was higher in the ovary removal group than in the ovary preservation group (54.4 vs 40.94 years; P < 0.001). The ovary preservation group showed an earlier FIGO stage than the ovary removal group. (P = 0.0264). There was a greater incidence of adjuvant chemotherapy administration in the removal group. There were no statistical differences in other baseline characteristics.When comparing the RFS and OS rates, there were no statistical differences between the preservation and removal groups. (recurrence free rate 98.5% vs 92.7%, p = 0.4360, and 5-year survival rate 98.6% vs 93.0%, p = 0.0892, respectively). Endometrioid histology (p=0.006) and post-operative adjuvant chemotherapy (p=0.0062) were related to OS, and adjuvant chemotherapy (p<0.001) and radiotherapy (p=0.005) were related to RFSConclusions: Ovary preservation in early stage endometrial cancer is worth considering, as it does not affect survival in early stage endometrial cancer patients

OPEC study: An international multicenter study of ovarian preservation in endometrial cancers

“…A large database reported a higher incidence of subsequent ovarian cancer development in EC patients under the age of 40 years 19 . Our findings were supported by results of studies evaluating the impact of early‐stage EC in patients with EC aged 40 years and below, wherein ovarian preservation did not have an adverse effect on survival 9,10,14,20 …”

“…19 Our findings were supported by results of studies evaluating the impact of early-stage EC in patients with EC aged 40 years and below, wherein ovarian preservation did not have an adverse effect on survival. 9,10,14,20 Meanwhile, sub-analysis of the data for patients under age 30 makes an additional contribution to the literature. There were not many studies showing the analysis of age subgroup analyses in 30 years and below, and age was not found to be a prognostic factor for OS and RFS in the present study.…”