1. Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer.
- Author
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Matsuo K, Cripe JC, Kurnit KC, Kaneda M, Garneau AS, Glaser GE, Nizam A, Schillinger RM, Kuznicki ML, Yabuno A, Yanai S, Garofalo DM, Suzuki J, St Laurent JD, Yen TT, Liu AY, Shida M, Kakuda M, Oishi T, Nishio S, Marcus JZ, Adachi S, Kurokawa T, Ross MS, Horowitz MP, Johnson MS, Kim MK, Melamed A, Machado KK, Yoshihara K, Yoshida Y, Enomoto T, Ushijima K, Satoh S, Ueda Y, Mikami M, Rimel BJ, Stone RL, Growdon WB, Okamoto A, Guntupalli SR, Hasegawa K, Shahzad MMK, Im DD, Frimer M, Gostout BS, Ueland FR, Nagao S, Soliman PT, Thaker PH, Wright JD, and Roman LD
- Subjects
- Adult, Cohort Studies, Disease-Free Survival, Endometrial Neoplasms surgery, Female, Humans, Hysterectomy methods, Hysterectomy statistics & numerical data, Japan epidemiology, Neoplasm Grading, Retrospective Studies, United States epidemiology, Carcinoma, Endometrioid epidemiology, Carcinoma, Endometrioid therapy, Endometrial Neoplasms epidemiology, Endometrial Neoplasms therapy, Neoplasms, Second Primary epidemiology, Organ Sparing Treatments statistics & numerical data, Ovary physiology
- Abstract
Objective: To examine the association between ovarian conservation and oncologic outcome in surgically-treated young women with early-stage, low-grade endometrial cancer., Methods: This multicenter retrospective study examined women aged <50 with stage I grade 1-2 endometrioid endometrial cancer who underwent primary surgery with hysterectomy from 2000 to 2014 (US cohort n = 1196, and Japan cohort n = 495). Recurrence patterns, survival, and the presence of a metachronous secondary malignancy were assessed based on ovarian conservation versus oophorectomy., Results: During the study period, the ovarian conservation rate significantly increased in the US cohort from 5.4% to 16.4% (P = 0.020) whereas the rate was unchanged in the Japan cohort (6.3-8.7%, P = 0.787). In the US cohort, ovarian conservation was not associated with disease-free survival (hazard ratio [HR] 0.829, 95% confidence interval [CI] 0.188-3.663, P = 0.805), overall survival (HR not estimated, P = 0.981), or metachronous secondary malignancy (HR 1.787, 95% CI 0.603-5.295, P = 0.295). In the Japan cohort, ovarian conservation was associated with decreased disease-free survival (HR 5.214, 95% CI 1.557-17.464, P = 0.007) and an increased risk of a metachronous secondary malignancy, particularly ovarian cancer (HR 7.119, 95% CI 1.349-37.554, P = 0.021), but was not associated with overall survival (HR not estimated, P = 0.987). Ovarian recurrence or metachronous secondary ovarian cancer occurred after a median time of 5.9 years, and all cases were salvaged., Conclusion: Our study suggests that adoption of ovarian conservation in young women with early-stage low-grade endometrial cancer varies by population. Ovarian conservation for young women with early-stage, low-grade endometrial cancer may be potentially associated with increased risks of ovarian recurrence or metachronous secondary ovarian cancer in certain populations; nevertheless, ovarian conservation did not negatively impact overall survival., (Copyright © 2019. Published by Elsevier Inc.)
- Published
- 2019
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