Ovarian preservation during the surgical treatment of early stage endometrial cancer: a nation-wide study conducted by the Korean Gynecologic Oncology Group.
OBJECTIVE
The objective of this study was to determine whether ovarian preservation is feasible in younger endometrial cancer patients.


METHODS
Endometrial cancer patients who underwent ovary-saving surgery were recruited from the tumor registries of 14 tertiary hospitals under the influence of the Korean Gynecologic Oncology Group (KGOG). Information regarding patient age, preoperative and intraoperative evaluations, pathologic reports, and follow-up results was abstracted from medical records.


RESULTS
One hundred and seventy five patients were eligible for this study. Mean patient age at the time of surgery was 38.5+/-8.3 years (range 25-57). Ovary-preserving surgery was performed in 101 (57.7%) patients who desired to preserve their ovaries, incidentally in 69 (39.4%) patients with preoperative diagnoses other than endometrial carcinoma, and in 5 patients (2.9%) with unknown reasons. Median duration of follow-up was 55.0 months (range 6.2-180.0 months). Recurrence free survival and overall survival rates were 94.3 and 93.3%, respectively. Seven of the 175 (4.0%) patients had documented recurrence, and no recurrences were observed in stage I patients with endometrioid histology. All 7 recurrences had risk factors that could have reasonably explained recurrence, namely, non-endometrioid histology (4/7), deep myometrial invasion (5/7), cervical stromal invasion (4/7), and inadequate adjuvant treatment (4/7). No metachronous ovarian malignancy occurred during follow-up. Ten (5.8%) deaths occurred during follow-up; five resulted from disease recurrence, and 5 from non-disease related causes.


CONCLUSIONS
Our findings suggest that ovarian preservation does not adversely impact the recurrence of early stage endometrial cancer.
Lee
Taek Sang
TS
Department of Obstetrics and Gynecology, Seoul Metropolitan Boramae Hospital, Republic of Korea.
Kim
Jae Weon
JW
Department of Obstetrics and Gynecology, Seoul National University Hospital, Republic of Korea. Electronic address: kjwksh@snu.ac.kr.
Kim
Tae Jin
TJ
Department of Obstetrics and Gynecology, Cheil General Hospital, Republic of Korea.
Cho
Chi Heum
CH
Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Republic of Korea.
Ryu
Sang Young
SY
Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Republic of Korea.
Ryu
Hee-Sug
HS
Department of Obstetrics and Gynecology, Ajou University Hospital, Republic of Korea.
Kim
Byoung Gie
BG
Department of Obstetrics and Gynecology, Samsung Seoul Hospital, Republic of Korea.
Lee
Keun Ho
KH
Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, Republic of Korea.
Kim
Yong Man
YM
Department of Obstetrics and Gynecology, Asan Medical Center, Republic of Korea.
Kang
Soon-Beom
SB
Department of Obstetrics and Gynecology, Seoul National University Hospital, Republic of Korea.
D000328:Adult; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000601:surgery*