The survival effect of ovary preservation in early stage endometrial cancer: a single institution retrospective analysis
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RESEARCH
Open Access
The survival effect of ovary preservation in early stage endometrial cancer: a single institution retrospective analysis Wonkyo Shin1, Sang-Yoon Park1,2, Sokbom Kang1,3,4, Myong Cheol Lim1,4,5,6 and Sang-Soo Seo1*
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 5year 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 RFS. Conclusions: Ovary preservation in early stage endometrial cancer is worth considering, as it does not affect survival in early stage endometrial cancer patients. Keywords: Endometrial cancer, Early stage, Ovary preservation, Menopause
Background Endometrial cancer has the highest incidence in gynecological cancers in Western countries [1], and the incidence is also increasing in Korea [2]. Conversely, endometrial cancer has a higher rate of early diagnosis than other gynecologic and solid cancers because symptoms such as irregular bleeding or discharge are easily detected * Correspondence: [email protected] 1 Center for Gynecologic Cancer, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Republic of Korea Full list of author information is available at the end of the article
by patients and diagnosis is possible with a simple endometrial curettage or hysteroscopic endometrial biopsy [3]. According to the National Comprehensive Cancer Network (NCCN) guidelines, early stage endometrial cancer is treated with total hysterectomy, bilateral salpingooophorectomy, and lymph node dissection, with subsequent staging according to the pathologic report. Adjunctive total salpingo-oophorectomy is th
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