子宫内膜癌(EC)保留卵巢手术的患者选择没有标准。在这项研究中,分析卵巢肿胀(OvS)的术中发现和有或没有卵巢转移的EC患者的临床病理特征,以确定卵巢转移的危险因素。纳入2012年至2019年间在我们医院接受EC手术的患者。在单变量分析中,在转移(+)病例中,所有特征均显著增高.在多变量分析中,淋巴空间入侵(LSI),宫颈间质受累(CSI),腹膜播散,和OvS是显著的危险因素。在无附件病理因素的I期和II期病例的单变量分析中,2型组织学类型,LSI,CSI,转移(+)病例中OvS显著增高。LSI,CSI,在多因素分析中,OvS和OvS是显著的危险因素。无子宫肌层侵犯≥1/2,CSI和宫外病变的1型组织学类型EC患者适用于卵巢保存。影响状态关于这个主题已经知道什么?患有子宫内膜癌(EC)的绝经前患者的数量正在增加。双侧卵巢切除术治疗EC导致手术性原发性卵巢功能不全,因此,已检查了保留卵巢的手术。然而,关于EC卵巢转移的危险因素的报道很少,也没有确定患者背景或病理因素的标准来确定是否适合保留卵巢手术.这项研究的结果加了什么?在单变量分析中,所有提示疾病进展的病理结果在卵巢转移病例中更为常见.在多变量分析中,淋巴空间入侵(LSI),宫颈间质受累(CSI),腹膜播散,和卵巢肿胀(OvS)被确定为卵巢转移的重要危险因素。在对没有附件病理因素的I期和II期病例的分析中,2型组织学类型,LSI,CSI,OvS在卵巢转移病例中明显更常见,和LSI,CSI,在多变量分析中,OvS是卵巢转移的重要危险因素。这些发现对临床实践和/或进一步研究有什么意义?没有肌层浸润深度≥1/2,CSI的1型组织学类型EC患者,或宫外病变可能是卵巢保存的合适病例。
There are no criteria for patient selection for ovarian-preserving surgery for endometrial cancer (EC). In this
study, intraoperative findings of ovarian swelling (OvS) and the clinicopathological features of patients with EC with or without ovarian metastasis were analysed to identify risk factors for ovarian metastasis. Patients who underwent surgery for EC between 2012 and 2019 at our hospital were enrolled. In univariate analysis, all features were significantly higher in metastasis(+) cases. In multivariate analysis, lymphatic space invasion (LSI), cervical stromal involvement (CSI), peritoneal dissemination, and OvS were significant risk factors. In univariate analysis in stage I and II cases classified without adnexal pathological factors, type 2 histologic type, LSI, CSI, and OvS were significantly higher in metastasis(+) cases. LSI, CSI, and OvS were significant risk factors in multivariate analysis. Patients with type 1 histologic type EC without myometrial invasion ≥1/2, CSI and extrauterine lesions are appropriate for ovarian preservation. IMPACT STATEMENTWhat is already known on this subject? The number of premenopausal patients with endometrial cancer (EC) is increasing. Bilateral oophorectomy for EC results in surgical primary ovarian insufficiency, and thus, surgery with ovarian preservation has been examined. However, there are few reports on risk factors for ovarian metastasis of EC and no established criteria for patient background or pathological factors to determine suitability for ovarian preservation surgery.What do the results of this
study add? In univariate analysis, all pathological findings suggestive of disease progression were more frequent in cases with ovarian metastases. In multivariate analysis, lymphatic space invasion (LSI), cervical stromal involvement (CSI), peritoneal dissemination, and ovarian swelling (OvS) were identified as significant risk factors for ovarian metastasis. In an analysis of stage I and II cases classified without adnexal pathological factors, type 2 histologic type, LSI, CSI, and OvS were significantly more common in cases with ovarian metastasis, and LSI, CSI, and OvS emerged as significant risk factors for ovarian metastasis in multivariate analysis.What are the implications of these findings for clinical practice and/or further research? Patients with type 1 histologic type EC without depth of myometrial invasion ≥1/2, CSI, or extrauterine lesions may be appropriate cases for ovarian preservation.