Removal of Ovaries May Not Be Necessary in Young Women with Endometrial Cancer
According to the results of a study published in the Journal of Clinical Oncology, removal of the ovaries may not be necessary in young women treated with hysterectomy for early-stage endometrial (uterine) cancer.
Endometrial cancer is cancer of the lining of the uterus. Although it is the most frequently diagnosed gynecologic cancer in the United States, long-term survival rates are high for endometrial cancer that is detected and treated early.
Standard treatment for endometrial cancer includes hysterectomy (removal of the uterus) and bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries). The reason for removal of the ovaries is that they could potentially harbor undetectable areas of cancer. In addition, among premenopausal women, removal of the ovaries reduces estrogen levels; because endometrial cancer is an estrogen-sensitive cancer, a reduction in estrogen levels could improve treatment outcomes.
The downside of oophorectemy among premenopausal women is that it induces menopause. Afterwards, women may experience symptoms such as hot flashes and vaginal dryness, and problems such as bone loss.
To explore the effects of oophorectomy on cancer survival and overall survival, researchers evaluated information from 3,269 young women (45 years of age or younger) with Stage I endometrial cancer. The information was collected from a large U.S. cancer registry (the Surveillance, Epidemiology, and End Results [SEER] database).
All the women were treated with hysterectomy. Most of the women also had their ovaries removed, but 402 (12% of the total) did not. The researchers compared survival among the women who had their ovaries removed with survival among the women who did not have their ovaries removed. In the analysis they accounted for factors such as age, tumor grade, and tumor stage (IA, IB, or IC).
The results indicated that overall and cancer-specific survival were similar among women who did and did not have their ovaries removed.
The researchers concluded that preservation of the ovaries may be safe for premenopausal women with early-stage, low-grade endometrial cancer; ovarian preservation was not linked with an increased risk of cancer death. They note, however, that additional research “is clearly warranted.”
Reference: Wright JD, Buck AM, Shah M, Burke WM, Schiff PB, Herzog TJ. Safety of ovarian preservation in premenopausal women with endometrial cancer. Journal of Clinical Oncology. Early online publication January 26, 2009.