title: Is hysterectomy needed in ovarian cancer?
abstract: BACKGROUND
  Hysterectomy is an integral part of ovarian cancer surgery. The authors have evaluated the uterine involvement in ovarian cancer in this study.
  
  
  OBJECTIVE
  Conventionally, removal of the uterus is considered an essential part of ovarian cancer surgery, but rationale for same in absence of its gross involvement is questionable. Aim of this study was to evaluate the microscopic involvement of uterus in ovarian cancer and whether there are any predictors of uterine involvement.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  The authors analyzed 128 patients of epithelial ovarian cancer (EOC) operated from 2004 January to 2008 June, who had not undergone hysterectomy previously. Data regarding their demographic, clinical, and pathological findings was collected and analyzed.
  
  
  METHODS
  Chi-square test.
  
  
  RESULTS
  Most of our patients (n=111) presented with stage III or above. Serous carcinoma was the most common histology encountered (86.7%). Uterus was grossly involved in only 19 patients and microscopic involvement was noted in 20 patients. Only one patient with absence of gross involvement had microscopic disease in the uterus. Involvement of the uterus was found to be independent of stage, type of tumor, laterality, and preoperative chemotherapy. The grade of tumor and gross uterine involvement were only factors that showed statistically significant correlation with microscopic uterine involvement. Only one patient had synchronous endometrial cancer.
  
  
  CONCLUSIONS
  Uterine involvement in EOC is not common. Absence of gross uterine involvement reliably predicts absence of microscopic disease.
authors.affiliation: Department of Surgical Oncology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
authors.forename: K
authors.initials: K
authors.lastname: Chitrathara
authors.forename: Z A
authors.initials: ZA
authors.lastname: Sheikh
authors.forename: D K
authors.initials: DK
authors.lastname: Vijaykumar
authors.forename: S
authors.initials: S
authors.lastname: Kuriakose
authors.forename: R
authors.initials: R
authors.lastname: Anupama
authors.forename: M
authors.initials: M
authors.lastname: Nandeesh
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008853:Microscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012704:Serous Membrane; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014599:Uterus / Q000473:pathology / Q000601:surgery*