Feasibility of ovarian preservation in patients with early stage endometrial carcinoma: A retrospective study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15064-15064
Author(s):  
T. Lee ◽  
J. Jung ◽  
J. Kim ◽  
J. Kim ◽  
N. Park ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Early Stage ◽  
Bowel Perforation ◽  
Ovarian Tissue ◽  
Endometrial Adenocarcinoma ◽  
Ovarian Metastasis ◽  
Surgical Removal ◽  
Ovarian Preservation ◽  
Synchronous Malignancy

15064 Background: The treatment of endometrial cancer involves surgical removal of the ovary; this elimination induces an abrupt menopause and may deteriorate the qualities of life. Therefore, ovarian preservation may be a consideration for premenopausal women. Our main objectives are to examine the occurrence of ovarian metastasis or synchronous malignancy and to evaluate the feasibility of ovarian preservation in patients with early stage endometrial carcinoma. Methods: We reviewed the medical records of 259 patients undergoing surgical treatment for endometrial cancer at a single institute from 1992 to 2004. Results: Among the 224 patients with endometrial adenocarcinoma who had undergone ovarian removal, cancer in ovarian tissue was detected in 21 cases (9.4%, 14 ovarian metastasis, 7 synchronous cancer). Synchronous ovarian cancer showed abnormal gross finding in all 7 cases. Thirteen cases of ovarian metastasis were high grade lesion in preoperative evaluation, or showed intraoperative peritoneal seeding or abnormal gross lesion around adnexa. In 35 patients, grossly normal ovary was saved selectively in compliance with patients’ need (19 bilateral, 16 unilateral). Thirty-one of 35 (89%) were under 45 years and mostly showed early stage (Ia, 24; Ib, 7; Ic, 1; IIa, 1; IIb, 2). Pre-operative MRI was available in 30 cases, and none of them showed findings suggesting tumor extension outside of uterus. In 2 cases of IIb, postoperative radiation therapy was done. There was no recurrence or death in all cases of ovarian preservation except one in which a patient died of sepsis caused by postoperative bowel perforation (median duration of follow-up, 76 mon.; range 3∼121). Conclusions: Ovarian preservation can be cautiously performed, preceded by a thorough preoperative and intraoperative assessment of the adnexa in young women with endometrial carcinoma. The patients who desire ovarian preservation should be counseled regarding the rate of ovarian metastasis or synchronous malignancy. No significant financial relationships to disclose.

Feasibility of ovarian preservation in patients with early stage endometrial carcinoma

2007 ◽  
Vol 104 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Taek Sang Lee ◽  
Ji Ye Jung ◽  
Jae Weon Kim ◽  
Noh-Hyun Park ◽  
Yong-Sang Song ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Ovarian Preservation

Undifferentiated endometrial carcinoma: a National Cancer Database analysis of prognostic factors and treatment outcomes

2019 ◽  
Vol 29 (7) ◽  
pp. 1126-1133
Author(s):  
Mariam AlHilli ◽  
Paul Elson ◽  
Lisa Rybicki ◽  
Sudha Amarnath ◽  
Bin Yang ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Endometrial Carcinoma ◽  
Treatment Outcomes ◽  
Survival Data ◽  
Early Stage ◽  
National Cancer Database ◽  
Early Stage Disease ◽  
Prognostic Groups

BackgroundUndifferentiated endometrioid endometrial carcinoma of the uterus is a rare, highly aggressive, and under-recognized subtype of endometrial cancer.ObjectiveThis study evaluates survival, prognostic factors for survival, and treatment outcomes associated with undifferentiated endometrial cancer.MethodsThe National Cancer Database was queried to identify patients with undifferentiated endometrial cancer who underwent definitive primary surgical treatment. Patients with all other histologic subtypes or incomplete treatment data were excluded. Univariable and multivariable Cox proportional hazards analyses were used to determine independent prognostic factors for survival. Points for each prognostic factor were assigned from regression coefficients in the final multivariable model and summed for a total score. Recursive partitioning analysis was used to determine cut-offs in the score to identify unique prognostic groups.ResultsAmong 349 404 women diagnosed with endometrial cancer from 2004 to 2013, 3994 (1.1%) met the criteria for diagnosis of undifferentiated endometrial cancer and 3486 had survival data. Median age at diagnosis was 65 years (interquartile range (IQR) 57–74) and 58% of patients had early stage disease. Median interval from diagnosis to surgery was 3.7 weeks (IQR 2.0–5.7). Five year overall survival was 57% (standard error (SE) 1%). Stage was the strongest predictor of survival, with a 15–20% decrement in 5 year survival for each advance in stage. Stage, age, race, and presence of comorbidities were independent predictors of survival and were used to categorize patients into five prognostic groups. Adjuvant therapy was associated with improved survival across most disease stages and prognostic groups. Multimodal adjuvant therapy was superior to unimodal treatment particularly in advanced stage unfavorable and very unfavorable groups.ConclusionIn women with undifferentiated endometrial cancer, survival is primarily driven by stage. Despite the poor overall prognosis of undifferentiated endometrial cancer, multimodal adjuvant therapy is a key component of treatment.

Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Haifeng Gu ◽  
Jundong Li ◽  
Yangkui Gu ◽  
Hua Tu ◽  
Yun Zhou ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Meta Analysis ◽  
Grey Literature ◽  
Disease Free Survival ◽  
Premenopausal Women ◽  
Cochrane Library ◽  
Ovarian Preservation ◽  
Significant Difference ◽  
Early Stage Endometrial Cancer

ObjectiveThe aim of this article was to investigate the survival impact of ovarian preservation in surgically treated patients with early-stage endometrial cancer using a meta-analysis.MethodsMajor online databases, including PubMed, EMBASE, Web of Science, the Cochrane Library, as well as Grey Literature database, were searched to collect studies on the effects of ovarian preservation compared with bilateral salpingo-oophorectomy (BSO) for surgical treatment in endometrial cancer patients. The literature search was performed up to April 2016. The results were analyzed using RevMan 5.0 software and Stata/SE 12.0 software.ResultsTotally, 7 retrospective cohort studies including 1419 patients in ovarian preservation group and 15,826 patients in BSO group were enrolled. Meta-analysis showed that there was no significant difference in overall survival between the patients treated with ovarian preservation and BSO (hazards ratio [HR], 1.00; 95% confidence interval [CI], 0.72–1.39; P = 1.00). Similar result was achieved in the young and premenopausal women (HR, 0.99; 95% CI, 0.70–1.39; P = 0.39). Furthermore, the disease-free survival of patients whose ovaries were preserved was slightly compromised but with no statistical significance (HR, 1.49; 95% CI, 0.56–3.93; P = 0.42).ConclusionsOvarian preservation may be safe in patients with early-stage endometrial cancer, and it could be cautiously considered in treating young and premenopausal women because it is not associated with an adverse impact on the patients’ survival. Given the inherent limitations of the included studies, further well-designed randomized controlled trial are needed to confirm and update this analysis.

Retrospective analysis of stage IC uterine cancer patients: A single center experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15573-e15573
Author(s):  
Nadire Kucukoztas ◽  
Selim Yalcin ◽  
Samed Rahatli ◽  
Ozlem Ozen ◽  
Nihan Haberal ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Uterine Cancer ◽  
Endometrial Adenocarcinoma ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Surgical Staging ◽  
Increased Risk

e15573 Background: Stage IC patients are at an increased risk of recurrence and overall worse prognosis compared with stage IA and IB patients. Adjuvant chemoherapy is utilized based on specific pathologic factors. The objective of this study is to evaluate treatment outcomes at a single institution in patients with 1988 FIGO stage IC endometrial adenocarcinoma. Methods: Records of the patients with FIGO stage IB (formerly IC) endometrial cancer were retrospectively evaluated. All patients were initially treated surgically with comprehensive staging lymphadenectomy. Results: A total of 85 patients were included. Patient and tumor characteristics are shown in the table. Median age of the patients was 60 (range 27-95). Fifty-nine patients had at least one co-morbid disease. Complete surgical staging including pelvic and paraaortic lymph node dissection was performed in all the patients. Sixteen patients (19%) received adjuvant chemotherapy, including 6 patients with serous cancer and one patient with small cell cancer. Paclitaxel/carboplatin was the preferred regimen in Median follow up was 30 months (range 10-61 months). Seven patients (8%) relapsed and 4 patients (5%) died on follow up. 5 year disease free survival was 89% and overall survival was 95%. One of the 16 patients (6.2%) who received chemotherapy and 6 of the 69 patients (8.7%) who did not receive relapsed/died on follow up. Survival analysis was not performed because of the low number of events in both groups. Conclusions: We found similar rates of recurrence and death with previous studies in stage IC endometrial cancer. Complete surgical staging is the mainstay of treatment. Marginally lower recurrence rate in chemotherapy treated patients delineate the need for prospective randomized data addressing the role of adjuvant systemic therapy in early-stage patients with endometrial adenocarcinoma. [Table: see text]

Why Routine Clinical Follow-up for Patients With Early Stage Endometrial Cancer Is Not Always Necessary: A Study on Women in South Wales

2014 ◽  
Vol 24 (3) ◽  
pp. 556-563 ◽  
Author(s):  
Lilly Aung ◽  
Robert E.J. Howells ◽  
Kenneth C.K. Lim ◽  
Emma Hudson ◽  
Peter W. Jones
Keyword(s):  
Endometrial Cancer ◽  
Confidence Interval ◽  
Endometrial Carcinoma ◽  
Early Stage ◽  
Progression Free Survival ◽  
Disease Recurrence ◽  
Hazard Ratio ◽  
Free Survival ◽  
South Wales

ObjectiveThis study aimed to examine the existing methods of follow-up in women who have undergone treatment of early endometrial carcinoma in South Wales and to assess if they are appropriate.DesignThis study used a retrospective analysis of follow-up data.SettingThis study was performed in the Virtual Gynaecological Oncology Centre, South Wales, United Kingdom.SampleThis study sample is composed of 552 women.MethodsData regarding follow-up were collected retrospectively from patient case notes and computerized data systems. Data were analyzed using the Pearson χ2 test, Cox proportional hazard regression analysis, and Kaplan-Meier curves.Main Outcome MeasuresThis study aimed to determine whether routine follow-up was beneficial in detecting disease recurrence and whether outcome was influenced by routine follow-up.ResultsBetween January 1, 2000, and December 31, 2010, 552 women were treated for early stage endometrial carcinoma. The 5-year survival was 81%, and the 5-year progression-free survival was 77%. Of these 552 women, 81 (15%) developed a disease recurrence; the majority (61/81 [75%]) recurred within 3 years. The median survival was 35 months compared with 47 months in patients who did not develop a recurrence. Of the 81 patients, 73 (90%) were symptomatic and only 5 patients were truly asymptomatic at follow-up. The most important and significant prognostic factor was “recurrent disease” with overall survival (hazard ratio, 2.20; P < 0.001; 95% confidence interval, 1.75–2.65) and progression-free survival (hazard ratio, 2.52; P < 0.001; 95% confidence interval, 2.09–2.95). “Asymptomatic recurrence” was not an independent predictor of outcome.ConclusionsRoutine follow-up for early endometrial cancer is not beneficial for patients because most were symptomatic at the time of detection. It does not significantly improve the outcome. We propose altering the follow-up time regimen and adopting alternative follow-up strategies for women in South Wales.

scholarly journals MRI-Based Radiomics Nomogram for Selecting Ovarian Preservation Treatment in Patients With Early-Stage Endometrial Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Bi Cong Yan ◽  
Xiao Liang Ma ◽  
Ying Li ◽  
Shao Feng Duan ◽  
Guo Fu Zhang ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Roc Curves ◽  
Primary Group ◽  
Endometrioid Adenocarcinoma ◽  
Validation Group ◽  
Cancer Antigen 125 ◽  
Ovarian Preservation ◽  
Early Stage Endometrial Cancer

BackgroundOvarian preservation treatment (OPT) was recommended in young women with early-stage endometrial cancer [superficial myometrial invasion (MI) and grades (G) 1/2-endometrioid adenocarcinoma (EEC)]. A radiomics nomogram was developed to assist radiologists in assessing the depth of MI and in selecting eligible patients for OPT.MethodsFrom February 2014 to May 2021, 209 G 1/2-EEC patients younger than 45 years (mean 39 ± 4.3 years) were included. Of them, 104 retrospective patients were enrolled in the primary group, and 105 prospective patients were enrolled in the validation group. The radiomics features were extracted based on multi-parametric magnetic resonance imaging, and the least absolute shrinkage and selection operator algorithm was applied to reduce the dimensionality of the data and select the radiomics features that correlated with the depth of MI in G 1/2-EEC patients. A radiomics nomogram for evaluating the depth of MI was developed by combing the selected radiomics features with the cancer antigen 125 and tumor size. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the radiomics nomogram and of radiologists without and with the aid of the radiomics nomogram. The net reclassification index (NRI) and total integrated discrimination index (IDI) based on the total included patients to assess the clinical benefit of radiologists with the radiomics nomogram were calculated.ResultsIn the primary group, for evaluating the depth of MI, the AUCs were 0.96 for the radiomics nomogram; 0.80 and 0.86 for radiologists 1 and 2 without the aid of the nomogram, respectively; and 0.98 and 0.98 for radiologists 1 and 2 with the aid of the nomogram, respectively. In the validation group, the AUCs were 0.88 for the radiomics nomogram; 0.82 and 0.83 for radiologists 1 and 2 without the aid of the nomogram, respectively; and 0.94 and 0.94 for radiologists 1 and 2 with the aid of the nomogram, respectively. The yielded NRI and IDI values were 0.29 and 0.43 for radiologist 1 and 0.23 and 0.37 for radiologist 2, respectively.ConclusionsThe radiomics nomogram outperformed radiologists and could help radiologists in assessing the depth of MI and selecting eligible OPTs in G 1/2-EEC patients.

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