title: [Ovarian preservation during treatment of early stage endometrial cancer].
abstract: Endometrial cancer staging is based on surgery. No matter the age of the patient, the surgical staging includes at least a total hysterectomy with bilateral salpingo-oophorectomy. Twenty to 25% of the patients diagnosed with endometrial cancer are younger than 45  years. Although some discrepancies among series may be observed, in this population, endometrial cancers are mainly of lower grade, confined to the uterus (without ovarian involvement) and of better prognosis compared to older patients. The impact of premature menopause on the quality of life, cardiovascular and bone systems should not be neglected. This raises the issue of the systematic bilateral oophorectomy legitimacy while staging endometrial cancer staging in young patient. Considering the literature, eligibility criteria to ovarian preservation in endometrial cancer would be: young patients, low-grade endometrioid tumor, disease limited to the uterus (absence of any extrauterine disease). The risk of occult ovarian lesions, either synchronous or metastatic, would than be close to 1%. The effects of residual hormonal stimulation are considered low. Nevertheless, bilateral oophorectomy should remain the standard. Oophorectomy preservation in endometrial cancer should be considered as an exception, and proposed as an individualized plan of care for patients with strict eligibility criteria.
authors.affiliation: Hôpital Notre-Dame, service de gynécologie oncologique, centre hospitalier de l'université de Montréal, CHUM, Montréal, Québec.mpoilblanc@yahoo.fr
authors.forename: Mathieu
authors.initials: M
authors.lastname: Poilblanc
authors.forename: Vanessa
authors.initials: V
authors.lastname: Samouelian
authors.forename: Denis
authors.initials: D
authors.lastname: Querleu
mesh_terms: D000328:Adult; D000367:Age Factors; D016889:Endometrial Neoplasms / Q000139:chemically induced / Q000473:pathology / Q000628:therapy*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D059351:Organ Sparing Treatments; D010051:Ovarian Neoplasms / Q000473:pathology; D010052:Ovariectomy / Q000379:methods; D010053:Ovary; D017697:Premenopause; D011379:Prognosis