Safety of ovarian preservation in young patients with early-stage endometrial cancer: A retrospective study and meta-analysis

摘要

Objective To evaluate the impact of ovarian preservation on overall survival in young women with early-stage endometrial cancer. Design Retrospective and meta-analysis. Setting Two medical centers. Patient(s) A total of 203 patients diagnosed with endometrial cancer (≤45 years) from 2000 until 2010. Intervention(s) Patients who underwent oophorectomy versus those whose ovaries were preserved. Main Outcome Measure(s) The overall survivals were compared. Independent factors that may affect the patients' survival were extracted and analyzed. A meta-analysis of the literature was carried out to further validate the findings. Result(s) Of 203 young patients, 169 patients (83.3%) underwent bilateral salpingo-oophorectomy, 20 patients had both ovaries preserved, and 14 patients had a single ovary preserved. Multivariate logistic regression identified intraoperative extrauterine disease as the most significant risk factor of ovarian involvement. A Kaplan-Meier curve and Cox proportional hazards models analyses found that ovarian preservation had no effect on overall survival. The findings were validated by meta-analysis. Conclusion(s) Ovarian preservation has no statistically significant impact on the overall survival of young patients with early-stage endometrial cancer. The ovaries should be preserved in this specific population after a thorough preoperative evaluation and an extensive intraoperative exploration.