Ovarian preservation in young women with endometrial cancer of endometrioid histology

Abstract

OBJECTIVE: To clarify the frequency and risk factors of ovarian metastasis in women with endometrial cancer of endometrioid histology. DESIGN: Retrospective observational study. SETTING: University of the Ryukyus Japan 1990-2011. POPULATION: Eighty-eight women ≤ 45 years of age with endometrial cancer of only endometrioid histology. METHODS: Clinicopathological factors from the medical records were used. Fisher's exact test and logistic regression analysis were used to analyze predictive factors for ovarian metastasis. MAIN OUTCOME MEASURES: Risk factors of ovarian malignancy. RESULTS: All women underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph node dissection. The median age was 39 years, and FIGO stage distributions were: stage I, 63 (71.6%) women; stage II, 14 (15.9%) women; and stage III, 11 (12.5%) women. Pathologically, ovarian metastasis was observed in four (4.5%) women. Only lymph node metastasis was a significant predictive factor for ovarian metastasis (p = 0.0038), and deep myometrial invasion was the only significant factor (p = 0.0085) for the prediction of lymph node metastasis. No ovarian malignancy was found in 72 women with invasion ≤ 50% myometrial depth and no enlargement of the ovaries. We observed ovarian metastasis in two (14.3%) of 14 women with deep myometrial invasion without ovarian tumor. CONCLUSION: Ovarian preservation surgery might be considered in endometrial cancer of endometrioid histology with ≤ 50% myometrial depth invasion with no ovarian mass after taking into account family history.