TY - JOUR
T1 - Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer
AU - Matsuo, Koji
AU - Cripe, James C
AU - Kurnit, Katherine C
AU - Kaneda, Michiko
AU - Garneau, Audrey S
AU - Glaser, Gretchen E
AU - Nizam, Aaron
AU - Schillinger, Rachel M
AU - Kuznicki, Michelle L
AU - Yabuno, Akira
AU - Yanai, Shiori
AU - Garofalo, Denise M
AU - Suzuki, Jiro
AU - St Laurent, Jessica D
AU - Yen, Ting-Tai
AU - Liu, Annie Y
AU - Shida, Masako
AU - Kakuda, Mamoru
AU - Oishi, Tetsuro
AU - Nishio, Shin
AU - Marcus, Jenna Z
AU - Adachi, Sosuke
AU - Kurokawa, Tetsuji
AU - Ross, Malcolm S
AU - Horowitz, Max P
AU - Johnson, Marian S
AU - Kim, Min K
AU - Melamed, Alexander
AU - Machado, Karime K
AU - Yoshihara, Kosuke
AU - Yoshida, Yoshio
AU - Enomoto, Takayuki
AU - Ushijima, Kimio
AU - Satoh, Shinya
AU - Ueda, Yutaka
AU - Mikami, Mikio
AU - Rimel, Bobbie J
AU - Stone, Rebecca L
AU - Growdon, Whitfield B
AU - Okamoto, Aikou
AU - Guntupalli, Saketh R
AU - Hasegawa, Kosei
AU - Shahzad, Mian M K
AU - Im, Dwight D
AU - Frimer, Marina
AU - Gostout, Bobbie S
AU - Ueland, Frederick R
AU - Nagao, Shoji
AU - Soliman, Pamela T
AU - Thaker, Premal H
AU - Wright, Jason D
AU - Roman, Lynda D
N1 - Copyright © 2019. Published by Elsevier Inc.
PY - 2019/8/16
Y1 - 2019/8/16
N2 - 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.
AB - 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.
U2 - 10.1016/j.ygyno.2019.08.007
DO - 10.1016/j.ygyno.2019.08.007
M3 - Article
C2 - 31427143
SN - 0090-8258
JO - Gynecologic Oncology
JF - Gynecologic Oncology
ER -