title: Outcomes of ovarian preservation in a cohort of premenopausal women with early-stage endometrial cancer: a Korean Gynecologic Oncology Group study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of ovarian preservation on the recurrence and survival rates of premenopausal women with early-stage endometrial cancer.
  
  
  METHODS
  Using medical records of premenopausal women who received primary surgical treatment for stage I-II endometrial cancer, the demographics and survival rates were compared retrospectively for patients who had ovarian preservation and those who underwent bilateral salpingo-oophorectomy. Cox proportional hazards models with inverse probability of treatment weighting (IPTW) based on propensity score were performed to adjust for selection bias between the two groups.
  
  
  RESULTS
  A total of 495 women were identified, including 176 patients who had ovarian preservation. The ovarian preservation group was younger (P<0.001) and had an earlier year of diagnosis (P=0.014), a lower prevalence of lymphadenectomy (P<0.001), and a marginally significant association with lower tumor grade (P=0.052). The Kaplan-Meier curve and the log rank test showed no difference in either recurrence-free survival (P=0.742) or overall survival (P=0.462) between the two groups. In a multivariate Cox model adjusted by IPTW and covariates, ovarian preservation had no effect on either recurrence (hazard ratio [HR], 0.73; 95% CI, 0.29-1.81) or overall survival (HR, 1.33; 95% CI, 0.43-4.09).
  
  
  CONCLUSIONS
  Ovarian preservation does not appear to be associated with an adverse impact on the outcomes of premenopausal women with early-stage endometrial cancer. The present study has useful implications for physicians counseling young women who want to preserve their ovaries.
authors.affiliation: Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Taek Sang
authors.initials: TS
authors.lastname: Lee
authors.forename: Jung-Yun
authors.initials: JY
authors.lastname: Lee
authors.forename: Jae-Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Sohee
authors.initials: S
authors.lastname: Oh
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: Jong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Kim
authors.forename: Chi Heum
authors.initials: CH
authors.lastname: Cho
authors.forename: Seok-Mo
authors.initials: SM
authors.lastname: Kim
authors.forename: Chan-Yong
authors.initials: CY
authors.lastname: Park
mesh_terms: D000328:Adult; D018269:Carcinoma, Endometrioid / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010053:Ovary / Q000502:physiology*; D017697:Premenopause; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Endometrial cancer; Ovarian preservation; Premenopausal women