Combinatorial Chemistry & High Throughput Screening

Rathnam Chaguturu 
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The Safety of Ovarian Preservation in Stage I Endometrial Endometrioid Adenocarcinoma Based on Propensity Score Matching

(E-pub Ahead of Print)

Author(s): Ting Hou, Zhen Wang, Yidi Sun, Chenglin Liu, Junyi Li, Yixue Li.

Abstract:

Most patients with early stage endometrioid adenocarcinoma are treated with hysterectomy and bilateral oophorectomy to prevent ovarian metastasis. But this surgical menopause leads to some long-term sequelae for premenopausal women, especially for young women of childbearing age. This population-based study was to evaluate the safety of ovarian preservation in young women with stage I endometrioid adenocarcinoma.Patients of age 50 or younger than 50 with stage I endometrioid adenocarcinoma were explored from the Surveillance, Epidemiology, and End Results program database during 2004 to 2013. Propensity score matching was used to randomize the dataset and reduce the selection biases of doctors. Univariate analysis and multivariate cox proportional hazards model were utilized to estimate the safety of ovarian preservation. A total of 7183 patients were identified, and ovarian preservation was performed in 863 (12 %) patients. Compared with women treated with oophorectomy, patients with ovarian preservation significantly tend to be younger at diagnosis (P-value < 0.001) and more likely diagnosed as stage IA endometrioid adenocarcinoma, to have better differentiated tumor tissues and smaller tumors, as well as less likely to undergo radiation and lymphadenectomy. 863 patients treated with oophorectomy were selected by propensity score matching. After propensity score matching, the differences of all characteristics between ovarian preservation and oophorectomy were not significant and potential confounders in the two groups were decreased. In univariate analysis of matched population, ovarian preservation had no effect on overall (P-value=0.928) and cancer-specific (P-value=0.390) mortality. In propensity-adjusted multivariate analysis, ovarian preservation was not significantly associated with overall (HR=0.69, 95%CI=0.41-1.68, P-value=0.611) and cancer-specific (HR=1.65, 95%CI=0.54-5.06, P-value=0.379) survival. Ovarian preservation is safe for young women with stage I endometrioid adenocarcinoma, which is not significantly associated with overall and cancer-specific mortality.

Keywords: premenopausal women, endometrioid adenocarcinoma, propensity score matching, ovarian preservation

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Article Details

VOLUME: 20
Year: 2017
(E-pub Ahead of Print)
DOI: 10.2174/1386207320666170417145856
Price: $95