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

Objective To evaluate the impact of ovarian preservation on overall survival in young women with early-stage endometrial cancer. Design Retrospective and meta-analysis. Setting Two medical centers. Patient(s) A total of 203 patients diagnosed with endometrial cancer (≤45 years) from 2000 until 2010....

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Bibliographic Details
Published in:Fertility and sterility 2013-09, Vol.100 (3), p.782-787.e5
Main Authors: Sun, Chaoyang, M.S, Chen, Gang, M.D, Yang, Zongyuan, M.S, Jiang, Jie, M.D, Yang, Xingsheng, M.D, Li, Na, M.D, Zhou, Bo, M.S, Zhu, Tao, M.D, Wei, Juncheng, M.D, Weng, Danhui, M.D, Ma, Ding, M.D, Wang, Changyu, M.D, Kong, Beihua, M.D
Format: Article
Language:English
Subjects:
Adult
Age Factors
animal ovaries
Carcinoma, Endometrioid - diagnosis
Carcinoma, Endometrioid - mortality
Carcinoma, Endometrioid - pathology
Carcinoma, Endometrioid - surgery
Endometrial cancer
Endometrial Neoplasms - diagnosis
Endometrial Neoplasms - mortality
Endometrial Neoplasms - pathology
Endometrial Neoplasms - surgery
Female
Fertility Preservation
Humans
Internal Medicine
meta-analysis
Middle Aged
Neoplasm Staging
Obstetrics and Gynecology
oophorectomy
Organ Sparing Treatments
Ovariectomy - adverse effects
Ovary - surgery
Patient Safety
patients
regression analysis
Retrospective Studies
risk factors
survival
Survival Analysis
uterine neoplasms
women
Young Adult
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Summary:Objective To evaluate the impact of ovarian preservation on overall survival in young women with early-stage endometrial cancer. Design Retrospective and meta-analysis. Setting Two medical centers. Patient(s) A total of 203 patients diagnosed with endometrial cancer (≤45 years) from 2000 until 2010. Intervention(s) Patients who underwent oophorectomy versus those whose ovaries were preserved. Main Outcome Measure(s) The overall survivals were compared. Independent factors that may affect the patients' survival were extracted and analyzed. A meta-analysis of the literature was carried out to further validate the findings. Result(s) Of 203 young patients, 169 patients (83.3%) underwent bilateral salpingo-oophorectomy, 20 patients had both ovaries preserved, and 14 patients had a single ovary preserved. Multivariate logistic regression identified intraoperative extrauterine disease as the most significant risk factor of ovarian involvement. A Kaplan-Meier curve and Cox proportional hazards models analyses found that ovarian preservation had no effect on overall survival. The findings were validated by meta-analysis. Conclusion(s) Ovarian preservation has no statistically significant impact on the overall survival of young patients with early-stage endometrial cancer. The ovaries should be preserved in this specific population after a thorough preoperative evaluation and an extensive intraoperative exploration.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2013.05.032