Abstract
Background: Premenopausal females having early-stage EC have a favorable prognosis. The guidelines of surgical treatment of EC have not been modified and it consists of total hysterectomy, bilateral salpingo-oophrectomy, pelvic and para-aortic lymphadenectomy, regardless of patients’ age or EC stage. The drawbacks of performing bilateral BSO are induction of surgical premature menopause which subsequently disturbs physical and psychosexual life in addition to increasing risk of diseases of the cardiovascular system and bone fractures. The aim of our study was to demonstrate if performing BSO in premenopausal females patients with early stage EC had survival benefits and improving long-term outcomes or not. Patients and methods; we included sixty EC patients and we have performed ovarian conservation in 30 (50%) of them, and performed BSO in the remaining 30 patients we have followed our patients for 5 years from December 2014 to December 2019. Results: Age of patients with ovarian conservation was younger than patients with BSO (p=0.032), have smaller tumor size (p=0.02), higher degree of tumor differentiation (p=0.025), less incidence of myomertrial invasion (p=0.004), less liability of lymphovascular invasion (p=0.001), more liability to endometrioid histopathological subtype (p=0.003), and earlier stage (p=0.009) than patients with BSO. There were no significant differences between both studied groups regarding recurrence of the tumor, recurrence free survival and overall survival rates. Conclusion: The current study tried to highlight the benefits of a more conservative approach by ovarian preservation in surgical management and staging of EC patients diagnosed in the early stage in young premenopausal women.
Highlights
Endometrial carcinoma is mostly a postmenopausal female’s malignancy, but in about quarter of patients who were diagnosed with Endometrial Carcinoma (EC) was premenopausal
There were no significant differences between both studied groups regarding recurrence of the tumor, recurrence free survival and overall survival rates
Standard surgical management strategies which included Bilateral salpigooophrectomy (BSO) in addition to hysterectomy and lymphadenectomy leading to induction of premature surgical menopause which leads to increasing rates of cardiovascular diseases, osteoporosis, bone fractures and worsens young females quality of life [5]
Summary
Endometrial carcinoma is mostly a postmenopausal female’s malignancy, but in about quarter of patients who were diagnosed with EC was premenopausal. Premenopausal females having early-stage EC have a favorable prognosis, with their 5 year overall survival rate is found to be more than 90%. The guidelines of surgical treatment of EC have not been modified and it consists of total hysterectomy, bilateral salpingooophrectomy, pelvic and para-aortic lymphadenectomy, regardless of patients’ age or EC stage [1]. The guidelines of surgical treatment of EC have not been modified and it consists of total hysterectomy, bilateral salpingo-oophrectomy, pelvic and para-aortic lymphadenectomy, regardless of patients’ age or EC stage. Conclusion: The current study tried to highlight the benefits of a more conservative approach by ovarian preservation in surgical management and staging of EC patients diagnosed in the early stage in young premenopausal women
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