Meta-analysis Of Feasibility Of Ovarian Preservation In Aged45Years And Younger Patients With Endometrial Carcinoma Of Early Stage

Background:Endometrial carcinoma (EC) is one of the most common female malignant tumors, which more likely to occur in postmenopausal women. In recent years, the incidence of EC continues to rise, with the extension of average life expectancy of women, fertility change in concept as well as the widely use of exogenous estrogen. EC patients who are younger than45years of age constitute are increasing year by year, getting younger and younger. It is well recognized that endometrial carcinoma is an estrogen-dependent neoplasm. In the treatment of endometrial cancer, total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSO) are usually performed. Although the BSO of young women might almost perfectly eradicate the possibility of residual cancer, the procedure induces an abrupt loss of estrogen, which causes climacteric symptoms, which include its deleterious impact on cardiovascular and bone health. Therefore, the early stage EC and the expected damage to quality of life resulting from castration have prompted considerations of saving ovaries during the treatment of young patients with early stage EC; however, the issue is highly controversial.Objective:This study was to assess the feasibility of ovarian preservation in young patients with early stage endometrial carcinoma.Method:In this study, Meta-analysis was used to collected all the published studies about the45years of age or younger with the early stage EC,who underwent ovarian preservation or underwent total abdominal hysterectomy and BSO. We searched the PUBMED, MEDLINE, Cochrane library, CNKI, CBMdisc, and reference lists of articles. Manual search was used to collect all the current references and research reports. Endometrial cancer related magazines in the library of Shandong University were searched manually. Languages were restricted to Chinese and English. Studies were selected according to strict inclusion and exclusion criteria. Data extraction and quality assessment was performed independently by the author. All the calculation and statistical tested with the Revman5.2software.Results:Five non-randomized controlled clinical trials including4418patients were enrolled in the study. With total abdominal hysterectomy and bilateral BSO compared to ovarian preservation, the risk of death and relapse was similar. The combined OR of all death risk was0.70,95%confidence interval(0.42-1.15), while the combined OR of relapse risk was0.87,95%confidence interval(0.44-1.70).Conclusion The present data show that ovarian preservation compared to bilateral salpingo-oophorectomy in early youth endometrial carcinoma can not increase the risk of death and relapse. The conclusions need high-quality randomized clinical trials to further confirm.