title: Ovarian metastasis in women with clinical stage I endometrial carcinoma.
abstract: BACKGROUND
  The incidence of ovarian metastasis in women with clinical stage I endometrial carcinoma is generally reported to be 5%, leading to the practice of removing the ovaries at surgery even in young patients.
  
  
  METHODS
  A retrospective study of 84 patients with clinical stage I endometrial cancer was carried out. Patients were excluded if the pathologic study revealed any evidence of extrauterine, apart from adnexal, spread or if the peritoneal cytology was positive. Patients with serous papillary or clear cell tumor histology were also excluded.
  
  
  RESULTS
  Sixty-seven patients fulfilled the inclusion criteria. Only three (4%) patients were found to be in surgical stage IIIA, all three had grade 3 tumors. Of these patients, two had uterine serosal involvement and one had a microscopic tumor implant in a fallopian tube; none had ovarian metastasis.
  
  
  CONCLUSIONS
  The risk of ovarian metastasis in women with well to moderately differentiated endometrial cancer, myometrial invasion limited to less than one half of the myometrium, negative peritoneal cytology and no evidence of metastatic lymph node spread is negligible. Young patients with a preoperative histological diagnosis of well to moderately differentiated endometrial carcinoma may be surgically staged, leaving the final decision regarding removal of the ovaries pending a thorough pathological review of the surgical specimens.
authors.affiliation: Department of Obstetrics and Gynecology, Barzilai Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel. gemer@barzi.haelth.gov.il
authors.forename: Ofer
authors.initials: O
authors.lastname: Gemer
authors.forename: Marina
authors.initials: M
authors.lastname: Bergman
authors.forename: Shmuel
authors.initials: S
authors.lastname: Segal
mesh_terms: D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000556:secondary* / Q000601:surgery; D010052:Ovariectomy; D012189:Retrospective Studies