© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Posted online January 26, 2009, on www.jco.org.
In the largest study to date on the safety of ovarian preservation in younger women surgically treated for early-stage endometrial cancer, researchers have found that overall survival rates are similar in women whose ovaries are removed, compared to those whose ovaries are left in place (preserved). Preserving the ovaries could spare many women from the side effects of surgically-induced menopause, such as hot flashes and vaginal dryness, as well as long-term increased risk of heart disease, osteoporosis and hip fractures. The study was published in the Journal of Clinical Oncology.
Surgical removal of the uterus (hysterectomy) is the standard treatment for endometrial cancer (cancer of the lining of the uterus). During the procedure, surgeons usually remove the ovaries as well, a procedure called oophorectomy. This has been done to reduce the risk of cancer spreading to the ovaries and to lower estrogen levels, which may fuel the growth of any remaining endometrial cancer cells; however, studies have shown these risks are small.
In this study, investigators compared five-year survival between 402 women aged 45 and younger who were diagnosed with stage I endometrial cancer (cancer confined to the uterus) whose ovaries were left in place, and 3,269 similar women with endometrial cancer whose ovaries were removed. All patients had a hysterectomy and were diagnosed between 1988 and 2004.
Five-year overall survival was similar between the two groups: Among women who had oophorectomy, 89 to 98 percent were still alive, depending on the extent of the cancer's growth. Similarly, five-year survival was 86 to 100 percent for women whose ovaries were left in place.
In 2008, approximately 40,100 women were diagnosed with endometrial cancer in the United States, and 7,470 died from the disease. About 8 percent of women diagnosed with endometrial cancer are under age 45.
What This Means for Patients
This research suggests that oncologists may not need to remove the ovaries during surgery in younger women with early-stage endometrial cancer, which has been the standard approach for many years. Women with early-stage endometrial cancer may want to discuss this option with their doctors. Choosing to leave the ovaries in place may help women retain quality of life by avoiding surgery-induced menopause.