title: Ovarian involvement in endometrioid adenocarcinoma of uterus.
abstract: OBJECTIVE
  Ovarian preservation is an option for some premenopausal patients with early stage endometrial cancer. Studies have shown that ovarian preservation in selected patients does not negatively impact survival outcomes. The objective of this study is to determine the frequency and characteristics of ovarian involvement when endometrial cancer is clinically confined to the uterus.
  
  
  METHODS
  Patients with endometrioid adenocarcinoma of uterus treated at our institution between 2000 and 2013 were identified. Patients with ovarian metastasis or synchronous primary ovarian cancer were included. Patients were excluded if there was gross extrapelvic disease on examination or imaging.
  
  
  RESULTS
  Seven hundred and fifty-nine patients were found to have endometrial cancer with the disease confined to the pelvis (stages I, II, and III). Fifteen patients (2%) had ovarian metastasis. Twenty-three patients (3%) had synchronous uterine and ovarian cancer. Most ovarian lesions (32 out of 38) were either enlarged or had abnormal appearing surface involvement. Six patients had microscopic ovarian involvement, accounting for 0.8% of the endometrial cancer patients with pelvis-confined disease. All of the patients were greater than 50 years of age. For those patients with microscopic ovarian metastasis, all had FIGO grade 3 disease, deep myometrial invasion, and extrauterine involvement of either cervix or lymph nodes.
  
  
  CONCLUSIONS
  Microscopic ovarian involvement occurred in 0.8% of patients with endometrial cancer. For premenopausal patients with endometrial cancer, normal appearing ovaries may be considered for preservation in the absence of extrauterine spread, grade 3 disease and deep myometrial invasion.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States. Electronic address: ken.lin@utsouthwestern.edu.
authors.forename: Ken Y
authors.initials: KY
authors.lastname: Lin
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: David S
authors.initials: DS
authors.lastname: Miller
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: April A
authors.initials: AA
authors.lastname: Bailey
authors.affiliation: Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Sajan J
authors.initials: SJ
authors.lastname: Andrews
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Kehoe
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Richardson
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Jayanthi S
authors.initials: JS
authors.lastname: Lea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000556:secondary*; D012189:Retrospective Studies
keywords: Endometrial cancer; Ovarian metastasis