Ovarian preservation in young women with endometrial cancer of endometrioid histology

ObjectiveTo clarify the frequency and risk factors of ovarian metastasis in women with endometrial cancer of endometrioid histology. DesignRetrospective observational study. SettingUniversity of the Ryukyus Japan 1990-2011. PopulationEighty-eight women 45years of age with endometrial cancer of only endometrioid histology. MethodsClinicopathological factors from the medical records were used. Fisher's exact test and logistic regression analysis were used to analyze predictive factors for ovarian metastasis. Main outcome measuresRisk factors of ovarian malignancy. ResultsAll women underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph node dissection. The median age was 39years, and FIGO stage distributions were: stage I, 63 (71.6%) women; stage II, 14 (15.9%) women; and stage III, 11 (12.5%) women. Pathologically, ovarian metastasis was observed in four (4.5%) women. Only lymph node metastasis was a significant predictive factor for ovarian metastasis (p=0.0038), and deep myometrial invasion was the only significant factor (p=0.0085) for the prediction of lymph node metastasis. No ovarian malignancy was found in 72 women with invasion 50% myometrial depth and no enlargement of the ovaries. We observed ovarian metastasis in two (14.3%) of 14 women with deep myometrial invasion without ovarian tumor. ConclusionOvarian preservation surgery might be considered in endometrial cancer of endometrioid histology with 50% myometrial depth invasion with no ovarian mass after taking into account family history.