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

ObjectiveTo compare the survival of patients with grade 1 intramucous endometrial adenocarcinoma according to the extent of surgery.DesignRetrospective cohort study.SettingNot 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.