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

Fertil Steril. 2012 Nov;98(5):1229-35. doi: 10.1016/j.fertnstert.2012.07.1142. Epub 2012 Sep 6.


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.

Publication types

  • Comparative Study
  • Video-Audio Media

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Chi-Square Distribution
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery*
  • Female
  • Fertility Preservation / adverse effects
  • Fertility Preservation / methods
  • Fertility Preservation / mortality*
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / mortality*
  • Infertility, Female / etiology
  • Infertility, Female / mortality
  • Infertility, Female / prevention & control*
  • Kaplan-Meier Estimate
  • Logistic Models
  • Multivariate Analysis
  • Neoplasm Grading
  • Organ Sparing Treatments / adverse effects
  • Organ Sparing Treatments / mortality*
  • Ovariectomy / adverse effects
  • Ovariectomy / mortality*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • SEER Program
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • United States