Can the Ovaries be preserved in Selected Cases of Endometrial Cancer?

Abstract

Objective: The purpose of this study was to estimate the frequency of ovarian metastasis in patients of endometrial cancer, to examine the clinico- pathological characteristics of cases with ovarian metastasis and to identify associated predictive factors in endometrial adenocarcinoma. Materials and Methods: We reviewed the clinical and pathological records of endometrial carcinoma cases diagnosed and treated at our institute between 2007 and 2015. Patient who received primary surgical treatment form the basis of this study. The histopathology reports were studied for information on the following: histology type, grades, depth of myometrial invasion, cervical involvement and lymph node status. Information regarding patient’s age was extracted from medical records. These data were then analyzed and compared for relation of ovarian metastasis with various risk factors. Results: Total 372 cases of endometrial carcinoma were evaluated. Out of these 32(8.6%) patients had ovarian metastases. No patient under the age of 40 years had ovarian metastasis. 13.3% of patients with more than 50% myometrial invasion and 39.2% of patients with cervix stromal involvement showed ovarian metastasis. There was no ovarian involvement with well differentiated adenocarcinoma as compare to 12.8% with poorly differentiated carcinoma and 38.9% with Non Endometrioid adenocarcinoma. Conclusion: The risk of ovarian metastasis in patients without predictable risk factors is minimal. Therefore, it may be possible to preserve ovaries in young women with low grade endometrial carcinoma confined to uterus. However further prospective studies are needed before current recommendation can be changed.