Safety of ovarian preservation for premenopausal patients with FIGO stage I grade 2 and 3 endometrioid endometrial adenocarcinoma

Abstract

Objectives: Investigate the utlization and outcomes of ovarian preservation (OP) for premenopausal patients with FIGO stage I grade 2 and 3 endometrioid endometrial carcinoma. Methods: Patients aged ≤ 45 years with no history of another tumor, diagnosed between 2004 and 2015 with a pathological stage I grade 2 or 3 endometrioid endometrial carcinoma, who underwent hysterectomy with or without bilateral salpingo-oophorectomy (BSO) and had at least one month of follow-up were drawn from the National Cancer Database. Clinico-pathological characteristics were compared with the chi-square test. Overall survival (OS) of patients who did and did not undergo BSO was calculated after generation of Kaplan-Meier curves and compared with the log-rank test. A Cox multivariate model was constructed to control for confounders. Results: A total of 2941 patients who met the inclusion criteria were identified; 200 (6.8%) patients did not undergo BSO. Rate of ovarian preservation was comparable between patients with grade 2 (n=163, 6.6%) and grade 3 (n=37, 7.7%) tumors, p=0.38. No difference between the OP and BSO groups was noted in terms of insurance status, type of treatment facility, patient race and presence of comorbidities, tumor size and depth of myometrial invasion, p>0.05. Patients who did not undergo BSO were younger (median 39 vs 41 years, p Conclusions: In a large cohort of patients with grade 2 and 3 FIGO stage I endometrioid carcinoma undergoing hysterectomy, ovarian preservation had no detrimental effect on overall survival.