Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer

Koji Matsuo, James C Cripe, Katherine C Kurnit, Michiko Kaneda, Audrey S Garneau, Gretchen E Glaser, Aaron Nizam, Rachel M Schillinger, Michelle L Kuznicki, Akira Yabuno, Shiori Yanai, Denise M Garofalo, Jiro Suzuki, Jessica D St Laurent, Ting-Tai Yen, Annie Y Liu, Masako Shida, Mamoru Kakuda, Tetsuro Oishi, Shin NishioJenna Z Marcus, Sosuke Adachi, Tetsuji Kurokawa, Malcolm S Ross, Max P Horowitz, Marian S Johnson, Min K Kim, Alexander Melamed, Karime K Machado, Kosuke Yoshihara, Yoshio Yoshida, Takayuki Enomoto, Kimio Ushijima, Shinya Satoh, Yutaka Ueda, Mikio Mikami, Bobbie J Rimel, Rebecca L Stone, Whitfield B Growdon, Aikou Okamoto, Saketh R Guntupalli, Kosei Hasegawa, Mian M K Shahzad, Dwight D Im, Marina Frimer, Bobbie S Gostout, Frederick R Ueland, Shoji Nagao, Pamela T Soliman, Premal H Thaker, Jason D Wright, Lynda D Roman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
JournalGynecologic Oncology
DOIs
Publication statusE-pub ahead of print - Aug 16 2019
Externally publishedYes

Fingerprint Dive into the research topics of 'Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer'. Together they form a unique fingerprint.

  • Cite this

    Matsuo, K., Cripe, J. C., Kurnit, K. C., Kaneda, M., Garneau, A. S., Glaser, G. E., Nizam, A., Schillinger, R. M., Kuznicki, M. L., Yabuno, A., Yanai, S., Garofalo, D. M., Suzuki, J., St Laurent, J. D., Yen, T-T., Liu, A. Y., Shida, M., Kakuda, M., Oishi, T., ... Roman, L. D. (2019). Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer. Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2019.08.007