Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Fertil Steril. 2013 Sep;100(3):782-7. doi: 10.1016/j.fertnstert.2013.05.032. Epub 2013 Jul 3.
To evaluate the impact of ovarian preservation on overall survival in young women with early-stage endometrial cancer.
Retrospective and meta-analysis.
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.
评估卵巢保留对早期子宫内膜癌年轻女性总生存率的影响。
回顾性和荟萃分析。
两家医疗中心。
共 203 名 2000 年至 2010 年期间被诊断为子宫内膜癌（≤45 岁）的患者。
接受卵巢切除术的患者与保留卵巢的患者。
比较总生存率。提取并分析可能影响患者生存的独立因素。对文献进行荟萃分析以进一步验证研究结果。
在 203 名年轻患者中，169 名（83.3%）接受了双侧输卵管卵巢切除术，20 名患者保留了双侧卵巢，14 名患者保留了单侧卵巢。多变量逻辑回归确定术中子宫外疾病是卵巢受累的最重要危险因素。Kaplan-Meier 曲线和 Cox 比例风险模型分析发现卵巢保留对总生存率无影响。荟萃分析验证了这一发现。
卵巢保留对早期子宫内膜癌年轻患者的总生存率无统计学显著影响。在充分的术前评估和广泛的术中探查后，应在这一特定人群中保留卵巢。
