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

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 measure(s): 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 and young age. 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.