Tanja Ignatov1, Holm Eggemann1, Elke Burger2, Olaf Ortmann3, Serban Dan Costa1, Atanas Ignatov4,5. 1. Department of Gynecology and Obstetrics, Otto-von-Guericke University, G.-Hauptmann Str. 35, 39108, Magdeburg, Germany. 2. Institute of Biometry and Medical Informatics, Otto-von-Guericke University, Magdeburg, Germany. 3. Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany. 4. Department of Gynecology and Obstetrics, Otto-von-Guericke University, G.-Hauptmann Str. 35, 39108, Magdeburg, Germany. atanas.ignatov@gmail.com. 5. Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany. atanas.ignatov@gmail.com.
Abstract
BACKGROUND: Oophorectomy is generally performed in patients with endometrial cancer despite the rate of ovarian metastasis being relatively low. PATIENTS AND METHODS: A multicenter retrospective registry-based study was performed in 2329 patients with endometrial cancer. The outcome measures were the incidence of ovarian metastasis and the impact on overall survival. RESULTS: Median follow-up was performed at 84 months. A total of 2158 women were eligible for analysis, of which 131 (6.1%) had ovarian metastasis. Women with ovarian metastasis were more likely to have > 50% myometrial invasion, undifferentiated nonendometrioid tumors, and lymph and vascular space invasion. The presence of < 50% myometrial invasion, endometrioid histology, well-differentiated cancer, and negative lymph and vascular space invasion were associated with a very low rate (0.5%) of ovarian metastasis. Notably, after matching for tumor histology and grade, myometrial invasion, and lymph and vascular space invasion, ovarian metastasis was not associated with a reduced median overall survival. CONCLUSIONS: Ovarian preservation should be offered to premenopausal women with endometrial cancer in whom myometrial invasion is less than 50%, the histological type is endometrioid and well-differentiated, and lymph and vascular space invasion is not involved.
BACKGROUND: Oophorectomy is generally performed in patients with endometrial cancer despite the rate of ovarian metastasis being relatively low. PATIENTS AND METHODS: A multicenter retrospective registry-based study was performed in 2329 patients with endometrial cancer. The outcome measures were the incidence of ovarian metastasis and the impact on overall survival. RESULTS: Median follow-up was performed at 84 months. A total of 2158 women were eligible for analysis, of which 131 (6.1%) had ovarian metastasis. Women with ovarian metastasis were more likely to have > 50% myometrial invasion, undifferentiated nonendometrioid tumors, and lymph and vascular space invasion. The presence of < 50% myometrial invasion, endometrioid histology, well-differentiated cancer, and negative lymph and vascular space invasion were associated with a very low rate (0.5%) of ovarian metastasis. Notably, after matching for tumor histology and grade, myometrial invasion, and lymph and vascular space invasion, ovarian metastasis was not associated with a reduced median overall survival. CONCLUSIONS: Ovarian preservation should be offered to premenopausal women with endometrial cancer in whom myometrial invasion is less than 50%, the histological type is endometrioid and well-differentiated, and lymph and vascular space invasion is not involved.
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Lancet Date: 2007-10-20 Impact factor: 79.321
Authors: Nita Karnik Lee; Michael K Cheung; Jacob Y Shin; Amreen Husain; Nelson N Teng; Jonathan S Berek; Daniel S Kapp; Kathryn Osann; John K Chan Journal: Obstet Gynecol Date: 2007-03 Impact factor: 7.661