title: Safety of uterine and/or ovarian preservation in young women with grade 1 intramucous endometrial adenocarcinoma: a comparison of survival according to the extent of surgery.
abstract: OBJECTIVE
  To compare the survival of patients with grade 1 intramucous endometrial adenocarcinoma according to the extent of surgery.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A cohort of 489 patients who were 40 years of age or younger with grade 1 intramucous endometrial adenocarcinoma.
  
  
  METHODS
  The patients were divided into the following three groups: 101 patients who underwent uterine preservation, 184 patients who underwent ovarian preservation, and 204 patients who underwent hysterectomy with oophorectomy.
  
  
  METHODS
  The demographics and survival rates were compared.
  
  
  RESULTS
  In the multivariate analysis, no factors were associated with ovarian preservation. In the multivariate analysis, the factors that were associated with uterine preservation were a later year of diagnosis and young age. In a multivariate Cox model, ovarian and uterine preservation had no effect on either cancer-specific or overall survival.
  
  
  CONCLUSIONS
  In patients with grade 1 intramucous endometrial adenocarcinoma, uterine and ovarian preservation were not associated with an increase in cancer-related mortality. Longer follow-up is needed to confirm the safety of a conservative approach toward the ovaries and/or the uterus.
authors.affiliation: Department of Obstetrics and Gynecology, Bichat University Hospital, Paris, France. martin.koskas@wanadoo.fr
authors.forename: Martin
authors.initials: M
authors.lastname: Koskas
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bendifallah
authors.forename: Dominique
authors.initials: D
authors.lastname: Luton
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D016009:Chi-Square Distribution; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000401:mortality*; D007247:Infertility, Female / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000401:mortality*; D010052:Ovariectomy / Q000009:adverse effects / Q000401:mortality*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States