Dinoi Giorgia, Lorusso Domenica, La Fera Eleonora, Restaino Stefano, Pafundi Pia Clara, Gioè Alessandro, Naccarato Laura, Palmieri Emilia, Musacchio Lucia, Di Stefano Ettore, Tarantino Vincenzo, Scambia Giovanni, Fanfani Francesco
UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Gynecologic Oncology Unit, Humanitas San Pio X, Humanitas University Rozzano, Milan, Italy.
Int J Gynecol Cancer. 2025 Jun;35(6):101846. doi: 10.1136/ijgc-2024-005482. Epub 2025 Apr 18.
Understanding ovarian involvement incidence and risk factors in women with endometrial cancer may inform the decision of ovary preservation.
Our retrospective study included all consecutive fully surgically staged patients with endometrial cancer who underwent primary surgery between January 2005 and November 2021, assessing the incidence of ovarian metastasis, its role as a prognostic factor for recurrence and death, and evaluated predictors of adnexal involvement.
Women with International Federation of Gynecology and Obstetrics (FIGO) 2009 IIIA endometrial cancer comprised 2.3% of the population (36 of 1535 included patients), 23 (63.9%) with endometrioid histology, and a median age of 57.0 years (range 47.7-66.7). A higher body mass index, post-menopausal status, endometrioid histotype, and β-catenin expression were associated with a lower risk of adnexal involvement. Conversely, dMMR phenotype, p53 expression, myometrial infiltration >50%, lymphovascular space invasion, and cervical stromal invasion were independent predictors of an increased risk of adnexal involvement. A total of 145 (9.5%) patients had adnexal involvement, with an incidence rate of 0.27/100 person-days. Overall survival for FIGO (2009) stage IIIA was 88.9%.
Our study showed that ovarian preservation may be considered for younger patients with low-risk endometrial cancer (G1 and G2 tumors, absence of lymphovascular space invasion, no cervical involvement, and myometrial invasion <50%), adding a favorable predictive role to higher body mass index and high β-catenin expression.
了解子宫内膜癌女性患者卵巢受累的发生率及危险因素，可为卵巢保留决策提供依据。
我们的回顾性研究纳入了2005年1月至2021年11月期间接受初次手术的所有连续的、经全面手术分期的子宫内膜癌患者，评估卵巢转移的发生率、其作为复发和死亡预后因素的作用，并评估附件受累的预测因素。
国际妇产科联盟（FIGO）2009年III A期子宫内膜癌女性占总人群的2.3%（1535例纳入患者中的36例），其中23例（63.9%）为子宫内膜样组织学类型，中位年龄为57.0岁（范围47.7 - 66.7岁）。较高的体重指数、绝经后状态、子宫内膜样组织学类型和β-连环蛋白表达与附件受累风险较低相关。相反，错配修复缺陷（dMMR）表型、p53表达、肌层浸润>50%、淋巴管间隙浸润和宫颈间质浸润是附件受累风险增加的独立预测因素。共有145例（9.5%）患者出现附件受累，发病率为0.27/100人日。FIGO（2009）III A期患者的总生存率为88.9%。
我们的研究表明，对于低风险子宫内膜癌（G1和G2肿瘤，无淋巴管间隙浸润、无宫颈受累且肌层浸润<50%）的年轻患者可考虑保留卵巢，较高的体重指数和高β-连环蛋白表达具有良好的预测作用。
