Safety of ovarian preservation in young patients with early-stage endometrial cancer: a retrospective study and meta-analysis

Fertil Steril. 2013 Sep;100(3):782-7. doi: 10.1016/j.fertnstert.2013.05.032. Epub 2013 Jul 3.


Objective: To evaluate the impact of ovarian preservation on overall survival in young women with early-stage endometrial cancer.

Design: Retrospective and meta-analysis.

Setting: Two medical centers.

Patient(s): A total of 203 patients diagnosed with endometrial cancer (≤45 years) from 2000 until 2010.

Intervention(s): Patients who underwent oophorectomy versus those whose ovaries were preserved.

Main outcome measure(s): The overall survivals were compared. Independent factors that may affect the patients' survival were extracted and analyzed. A meta-analysis of the literature was carried out to further validate the findings.

Result(s): Of 203 young patients, 169 patients (83.3%) underwent bilateral salpingo-oophorectomy, 20 patients had both ovaries preserved, and 14 patients had a single ovary preserved. Multivariate logistic regression identified intraoperative extrauterine disease as the most significant risk factor of ovarian involvement. A Kaplan-Meier curve and Cox proportional hazards models analyses found that ovarian preservation had no effect on overall survival. The findings were validated by meta-analysis.

Conclusion(s): Ovarian preservation has no statistically significant impact on the overall survival of young patients with early-stage endometrial cancer. The ovaries should be preserved in this specific population after a thorough preoperative evaluation and an extensive intraoperative exploration.

Keywords: Endometrial cancer; oophorectomy; survival.

Publication types

  • Meta-Analysis
  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Carcinoma, Endometrioid / diagnosis
  • Carcinoma, Endometrioid / mortality
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / surgery*
  • Endometrial Neoplasms / diagnosis
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery*
  • Female
  • Fertility Preservation*
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Organ Sparing Treatments*
  • Ovariectomy / adverse effects*
  • Ovary / surgery*
  • Patient Safety
  • Retrospective Studies
  • Survival Analysis
  • Young Adult