Risk Factors Analysis Of Ovarian Metastasis In Endometrial Carcinoma And Feasibility Of Ovarian Preservation

Objective: To study the clinicopathological characteristics and relatedfactors of ovarian metastasis and discuss the indications and feasibility ofovarian preservation in endometrial carcinoma.Materials and Methods: Through a prospective research,a total of206patients who underwent procedure from January2007to December2013at theFourth Affiliated Hospital of Guangxi Medical University were included. Allpatients were restaged according to International Federation of Gynecology andObstetrics revised surgical-pathologic staging standard in2009. Parameters suchas age, clinical symptoms, previous obstetric history, preoperative serumCA-125level, diagnostic approach, clinical stage, surgical procedure, surgicalscope, surgical-pathologic stage,pathologic type, histological grade, ovarianmetastasis were analyzed. The relationship between ovarian metastasis andrelative factors were analyzed by using univariate and multivariate analysis.Results: In this study，the average age of all patients was52.43±8.48years old, there were100cases in menopausal, accounting for48.54%. Thecardinal symptom of endometrial carcinoma was abnormal vaginal bleeding anddischarge, accounting for93.20%.There were88cases of postmenopausalvaginal bleeding in the patients. There were15cases of ovarian metastasis,accounted for7.28%, of which8cases of bilateral ovaries transferd, accountedfor53.33%of ovarian metastasis.There were10cases who presented normalovary size,no abnormal appearance. In univariate analysis, low differentiation,deep myometrium invasion, cervical invasion, pelvic lymph node metastatic,high serum CA-125levels,vessel invasion,clinical stage had higherovarian metastatic rate (p<0.05); age more than45years, special pathologictypes, highly differentiation and para-aortic lymph node had lower ovarianmetastatic rate (p＞0.05); in multivariate analysis, low differentiation and highserum CA-125levels were high factors for ovarian metastasis in endometrialcancer (p<0.05).Conclusion:1. The rate of ovarian metastasis in endometrial cancer was7.28%（15/206）, therate of bilateral ovarian metastasis was3.88%（8/206）.2. Low differentiation, deep myometrium invasion, cervical invasion, pelviclymph node metastatic,high serum CA-125levels,vessel invasion,clinical stagewere high factors for ovarian metastasis in endometrial cancer.3. Low differentiation and high serum CA-125levels were the most importantfactors.4．Endometrial cancer with ovarian metastasis was the presence of high riskfactors. For clinical stageⅠendometrial cancer, patients who met the followingconditions could preserved unilateral or bilateral ovaries: after a strictpreoperative evaluation, fullly intraoperative probetation, high differentiationendometrioid adenocarcinoma， normal serum CA-125levels, withoutmyometrial and cervical invasion, without vessel invasionmay，without pelviclymph node metastatic, and could followed up closely postoperation.However,this research was a retrospective study, still need multi-center, prospectiverandomized controlled trials of large sample to demonstrate.