Ken Y Lin1, David S Miller2, April A Bailey3, Sajan J Andrews4, Siobhan M Kehoe2, Debra L Richardson2, Jayanthi S Lea2. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States. Electronic address: ken.lin@utsouthwestern.edu. 2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States. 3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States. 4. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Abstract
OBJECTIVE: Ovarian preservation is an option for some premenopausal patients with early stage endometrial cancer. Studies have shown that ovarian preservation in selected patients does not negatively impact survival outcomes. The objective of this study is to determine the frequency and characteristics of ovarian involvement when endometrial cancer is clinically confined to the uterus. METHODS: Patients with endometrioid adenocarcinoma of uterus treated at our institution between 2000 and 2013 were identified. Patients with ovarian metastasis or synchronous primary ovarian cancer were included. Patients were excluded if there was gross extrapelvic disease on examination or imaging. RESULTS: Seven hundred and fifty-nine patients were found to have endometrial cancer with the disease confined to the pelvis (stages I, II, and III). Fifteen patients (2%) had ovarian metastasis. Twenty-three patients (3%) had synchronous uterine and ovarian cancer. Most ovarian lesions (32 out of 38) were either enlarged or had abnormal appearing surface involvement. Six patients had microscopic ovarian involvement, accounting for 0.8% of the endometrial cancer patients with pelvis-confined disease. All of the patients were greater than 50 years of age. For those patients with microscopic ovarian metastasis, all had FIGO grade 3 disease, deep myometrial invasion, and extrauterine involvement of either cervix or lymph nodes. CONCLUSIONS: Microscopic ovarian involvement occurred in 0.8% of patients with endometrial cancer. For premenopausal patients with endometrial cancer, normal appearing ovaries may be considered for preservation in the absence of extrauterine spread, grade 3 disease and deep myometrial invasion.
OBJECTIVE: Ovarian preservation is an option for some premenopausal patients with early stage endometrial cancer. Studies have shown that ovarian preservation in selected patients does not negatively impact survival outcomes. The objective of this study is to determine the frequency and characteristics of ovarian involvement when endometrial cancer is clinically confined to the uterus. METHODS:Patients with endometrioid adenocarcinoma of uterus treated at our institution between 2000 and 2013 were identified. Patients with ovarian metastasis or synchronous primary ovarian cancer were included. Patients were excluded if there was gross extrapelvic disease on examination or imaging. RESULTS: Seven hundred and fifty-nine patients were found to have endometrial cancer with the disease confined to the pelvis (stages I, II, and III). Fifteen patients (2%) had ovarian metastasis. Twenty-three patients (3%) had synchronous uterine and ovarian cancer. Most ovarian lesions (32 out of 38) were either enlarged or had abnormal appearing surface involvement. Six patients had microscopic ovarian involvement, accounting for 0.8% of the endometrial cancerpatients with pelvis-confined disease. All of the patients were greater than 50 years of age. For those patients with microscopic ovarian metastasis, all had FIGO grade 3 disease, deep myometrial invasion, and extrauterine involvement of either cervix or lymph nodes. CONCLUSIONS: Microscopic ovarian involvement occurred in 0.8% of patients with endometrial cancer. For premenopausal patients with endometrial cancer, normal appearing ovaries may be considered for preservation in the absence of extrauterine spread, grade 3 disease and deep myometrial invasion.
Authors: Koji Matsuo; James C Cripe; Katherine C Kurnit; Michiko Kaneda; Audrey S Garneau; Gretchen E Glaser; Aaron Nizam; Rachel M Schillinger; Michelle L Kuznicki; Akira Yabuno; Shiori Yanai; Denise M Garofalo; Jiro Suzuki; Jessica D St Laurent; Ting-Tai Yen; Annie Y Liu; Masako Shida; Mamoru Kakuda; Tetsuro Oishi; Shin Nishio; Jenna Z Marcus; Sosuke Adachi; Tetsuji Kurokawa; Malcolm S Ross; Max P Horowitz; Marian S Johnson; Min K Kim; Alexander Melamed; Karime K Machado; Kosuke Yoshihara; Yoshio Yoshida; Takayuki Enomoto; Kimio Ushijima; Shinya Satoh; Yutaka Ueda; Mikio Mikami; Bobbie J Rimel; Rebecca L Stone; Whitfield B Growdon; Aikou Okamoto; Saketh R Guntupalli; Kosei Hasegawa; Mian M K Shahzad; Dwight D Im; Marina Frimer; Bobbie S Gostout; Frederick R Ueland; Shoji Nagao; Pamela T Soliman; Premal H Thaker; Jason D Wright; Lynda D Roman Journal: Gynecol Oncol Date: 2019-08-16 Impact factor: 5.482