Ovarian preservation in low-grade endometrial cancer and endometrial intraepithelial neoplasia: outcomes and long-term health sequelae

Abstract

Objectives: To evaluate the rate of ovarian preservation and investigate post-operative health outcomes in premenopausal women undergoing surgery for low grade endometrial cancer or endometrial intraepithelial neoplasia (EIN). Methods: Institutional review board (IRB) approval was obtained for this retrospective cohort study. Inclusion criteria were premenopausal women less than 50 years old diagnosed with low grade (grade 1 or 2) endometrioid endometrial adenocarcinoma or EIN from 2008 - 2019 who underwent primary surgery. Women were excluded if there was evidence of advanced stage disease preoperatively. Chi-squared and Fisher exact tests were used for statistical analysis. Results: One hundred forty seven women met inclusion criteria, 35 with EIN and 112 with adenocarcinoma. Women with EIN were more likely to undergo ovarian preservation compared to women with adenocarcinoma, 35.6% vs 13.4% (p Conclusions: Despite mounting evidence that ovarian preservation does not influence cancer recurrence, rates of ovarian preservation in our cohort of premenopausal women with low grade endometrial cancer and EIN were very low. Menopausal symptoms were significantly worse in women who underwent oophorectomy. Prospective assessment of health outcomes and quality of life measures in this population are warranted to further affect surgical decision making.