Young patients with endometrial cancer: how many could be eligible for fertility-sparing treatment?
OBJECTIVE
To assess the characteristics of young women with endometrial carcinoma, and evaluate those potentially eligible for conservative therapy.


METHODS
We identified women diagnosed with endometrial cancer between 1970 and 2005 at the population-based Geneva Cancer Registry (n=1365). We classified patients into two age groups (< or =45 and >45 years old). Differences in demographic, tumor, diagnostic and treatment characteristics were tested with chi square. Kaplan-Meier analysis was used to calculate survival from endometrial cancer and the log-rank test to analyze differences in survival between the two groups.


RESULTS
The young group comprised 44 (3.2%) women and the old group 1321 (96.8%) women. Synchronous ovarian malignancies were found in six patients (14%) in the young group, compared with 23 (2%) in the old group (P<0.001). Tumor stage was also different between the two groups, principally because of more stage II among the young (P=0.012). Histological tumor type, grade and specific endometrial cancer 5-year survival did not significantly differ between the two groups. According to final histopathologic evaluation, eight patients from the young group had FIGO stage IA, grade I disease, i.e. may have been eligible for fertility-sparing treatment, corresponding to an incidence rate of 0.3/100,000.


CONCLUSIONS
No significant difference regarding tumor characteristics and survival between young and older patients was observed, except stage of disease and rate of synchronous ovarian malignancy. Conservative approach is a meaningful quality of life goal for patients with cancer, but only suitable for a limited number of patients.
Navarria
Isabelle
I
Department of Obstetrics and Gynecology, Surgical Gynecologic Oncology Unit, Geneva University Hospitals, 1211 Geneva 14, Switzerland. isabelle.navarria@hcuge.ch
Usel
Massimo
M
Rapiti
Elisabetta
E
Neyroud-Caspar
Isabelle
I
Pelte
Marie-Françoise
MF
Bouchardy
Christine
C
Petignat
Patrick
P
D000328:Adult; D000367:Age Factors; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D055815:Young Adult