Outcomes of ovarian preservation in a cohort of premenopausal women with early-stage endometrial cancer: a Korean Gynecologic Oncology Group study

Gynecol Oncol. 2013 Nov;131(2):289-93. doi: 10.1016/j.ygyno.2013.08.024. Epub 2013 Aug 29.


Objective: The aim of this study was to evaluate the impact of ovarian preservation on the recurrence and survival rates of premenopausal women with early-stage endometrial cancer.

Methods: Using medical records of premenopausal women who received primary surgical treatment for stage I-II endometrial cancer, the demographics and survival rates were compared retrospectively for patients who had ovarian preservation and those who underwent bilateral salpingo-oophorectomy. Cox proportional hazards models with inverse probability of treatment weighting (IPTW) based on propensity score were performed to adjust for selection bias between the two groups.

Results: A total of 495 women were identified, including 176 patients who had ovarian preservation. The ovarian preservation group was younger (P<0.001) and had an earlier year of diagnosis (P=0.014), a lower prevalence of lymphadenectomy (P<0.001), and a marginally significant association with lower tumor grade (P=0.052). The Kaplan-Meier curve and the log rank test showed no difference in either recurrence-free survival (P=0.742) or overall survival (P=0.462) between the two groups. In a multivariate Cox model adjusted by IPTW and covariates, ovarian preservation had no effect on either recurrence (hazard ratio [HR], 0.73; 95% CI, 0.29-1.81) or overall survival (HR, 1.33; 95% CI, 0.43-4.09).

Conclusions: Ovarian preservation does not appear to be associated with an adverse impact on the outcomes of premenopausal women with early-stage endometrial cancer. The present study has useful implications for physicians counseling young women who want to preserve their ovaries.

Keywords: Endometrial cancer; Ovarian preservation; Premenopausal women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Endometrioid / mortality
  • Carcinoma, Endometrioid / surgery
  • Carcinoma, Endometrioid / therapy*
  • Cohort Studies
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery
  • Endometrial Neoplasms / therapy*
  • Female
  • Fertility Preservation / adverse effects
  • Fertility Preservation / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Ovary / physiology*
  • Premenopause
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Treatment Outcome