Ovarian metastasis in patients with endometrial cancer: risk factors and impact on survival

J Cancer Res Clin Oncol. 2018 Jun;144(6):1103-1107. doi: 10.1007/s00432-018-2628-2. Epub 2018 Mar 14.

Abstract

Background: Oophorectomy is generally performed in patients with endometrial cancer despite the rate of ovarian metastasis being relatively low.

Patients and methods: A multicenter retrospective registry-based study was performed in 2329 patients with endometrial cancer. The outcome measures were the incidence of ovarian metastasis and the impact on overall survival.

Results: Median follow-up was performed at 84 months. A total of 2158 women were eligible for analysis, of which 131 (6.1%) had ovarian metastasis. Women with ovarian metastasis were more likely to have > 50% myometrial invasion, undifferentiated nonendometrioid tumors, and lymph and vascular space invasion. The presence of < 50% myometrial invasion, endometrioid histology, well-differentiated cancer, and negative lymph and vascular space invasion were associated with a very low rate (0.5%) of ovarian metastasis. Notably, after matching for tumor histology and grade, myometrial invasion, and lymph and vascular space invasion, ovarian metastasis was not associated with a reduced median overall survival.

Conclusions: Ovarian preservation should be offered to premenopausal women with endometrial cancer in whom myometrial invasion is less than 50%, the histological type is endometrioid and well-differentiated, and lymph and vascular space invasion is not involved.

Keywords: Endometrial cancer; Metastasis; Ovarian.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Endometrial Neoplasms / mortality*
  • Endometrial Neoplasms / pathology*
  • Female
  • Germany / epidemiology
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / secondary*
  • Retrospective Studies
  • Risk Factors