Analysis Of The Risk Of The Ovarian Metastasis In Patients With Endometrial Carcinoma And The Ovary Preservation

Objective:The reseach analyze the risk factors for ovarian metastasis in patients with endometrial carcinoma and discuss the feasibility of ovarian preservation at the time of operation in early endometrial carcinoma by retrospectively studying the pathological and clinical features and outcomes of endometrial carcinoma patients who were diagnosed and treated in Qilu hospital of Shan Dong University from Jan2012to Dec2013.Methods:Collecting information of patients who were first diagnosed with endometrial carcinoma in Qilu hospital of Shan Dong University from Jan2012to Dec2013.All of these patients had been treated with surgery (TH/RH+BSO) and the postoperative pathology affirmed endometrial carcinoma excluding other malignant tumors.The patients is staged by2009FIFO.Patients of Stage I were treated with total hysteretomy and bilateral salpingo-oophorectomy(TH/BSO),Patients of Stage II were treated with radical hysterectomy and bilateral salpingo-oophorectomy(RH/BSO),pelvic and para-aortic lymph node dissection is performed based on patients’ conditions and intraoperative inspections. Some patients may not be candidates for lymph node dissection.Adjuvant treatment is needed if risks do exist.The standard of ovarian metastasis in patients with early endometrial carcinoma is based on what Uibright and Roth claimed. Ovarian metastasis was differentiated from synchronous ovarian primary cancer either by a multinodular ovarian pattern or two or more of the following criteria:size of ovary(ies)smaller than5cm, bilateral ovarian involvement, more than50%of depth of myometrial invasion, vascular invasion,and tubal lumen involvement. During the operation,the grossly abnormal or tumor is termed abvious metastasis. The grossly normal but post-operation pathology affimed ovarian metastasis is called recessive metastasis.Statistical Methods:Datas are analyzed by SPSS13.0software packet, and categorical data is analysed by Chi-square test.Multivariate logistic regression was performed to identify independent risk factors associated with coexisting ovarian cancer. P<0.05was defined as statistically significant.ResultsIn273endometrial carcinoma,13(4.74%)is ovarian metastasis while3(1.1%) is recessive metastasis.According to single factor analysis,comparing the group of ovarian metastasis with ovarian non-metastasis,the level of preoperative serum CA125,histologic type,and lymphnode matastasis are independent risk factors of ovarian metastasis in patients with early endometrial carcinoma.Multifactorial analysis appears that the level of preoperative serum CA125is independent risk factor in prognosis of ovarian metastasis in patients with early endometrial carcinoma.Conclusions1.The level of preoperative serum CA125is independent risk factor in prognosis of ovarian metastasis in patients with early endometrial carcinoma; 2.The rate of ovarian metastasis is4.74%,recessive metastasis is1.1%;3.Through careful preoperative assessment and intraoperative inspection of ovaries,ovarian preservation is practicable if the above-mentioned risk factor not exist.