Safety of uterine and or ovarian preservation in young women with grade 1 intramucous endometrial adenocarcinoma A comparison of survival according to the extent of surgery

Capsule:
Analyzing 489 patients who were 40 years of age or younger with grade 1 intramucous endometrial adenocarcinoma, uterine and ovarian preservation was not associated with an increase in cancer-related mortality.

Authors:
Martin Koskas, M.D., Sofiane Bendifallah, M.D., Dominique Luton, M.D., Ph.D., Emile Daraï, M.D., Ph.D., Roman Rouzier, M.D., Ph.D.

Volume 98, Issue 5, Pages 1229-1235, November 2012

Abstract:

Objective:
To compare the survival of patients with grade 1 intramucous endometrial adenocarcinoma according to the extent of surgery.

Design:
Retrospective cohort study.

Setting:
Not applicable.

Patient(s):
A cohort of 489 patients who were 40 years of age or younger with grade 1 intramucous endometrial adenocarcinoma.

Intervention(s):
The patients were divided into the following three groups: 101 patients who underwent uterine preservation, 184 patients who underwent ovarian preservation, and 204 patients who underwent hysterectomy with oophorectomy.

Main Outcome Measures:
The demographics and survival rates were compared.

Result(s):
In the multivariate analysis, no factors were associated with ovarian preservation. In the multivariate analysis, the factors that were associated with uterine preservation were a later year of diagnosis (p<0.001) and young age (p<0.001). In a multivariate Cox model, ovarian and uterine preservation had no effect on either cancer-specific or overall survival. Conclusion(s):
In patients with grade 1 intramucous endometrial adenocarcinoma, uterine and ovarian preservation were not associated with an increase in cancer-related mortality. Longer follow up is needed to confirm the safety of a conservative approach toward the ovaries and/or the uterus.

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