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

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

Volume: 20 Issue: 7

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

Affiliation:

• School of Biological Engineering, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237,China

• Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai 200011,China

Keywords: Premenopausal women, endometrioid adenocarcinoma, propensity score matching, ovarian preservation.

Abstract: Background: Most patients with early stage endometrial endometrioid adenocarcinoma (EEAC) are treated with hysterectomy and bilateral oophorectomy. But this surgical menopause leads to 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 EEAC.

Methods: Patients of age 50 or younger with stage I EEAC were explored from the Surveillance, Epidemiology and End Results program database during 2004 to 2013. Propensity score matching was used to randomize the data set and reduce the selection biases of doctors. Univariate analysis and multivariate cox proportional hazards model were utilized to estimate the safety of ovarian preservation.

Results: 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 EEAC, 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 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 propensityadjusted 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, Pvalue= 0.379) survival.

Conclusion: Ovarian preservation is safe for young women with stage I EEAC, which is not significantly associated with overall and cancer-specific mortality.

Cite this article as:

Hou Ting , Sun Yidi , Li Junyi, Liu Chenglin, Wang Zhen , Li Yixue*, Lu Yuan *, The Safety of Ovarian Preservation in Stage I Endometrial Endometrioid Adenocarcinoma Based on Propensity Score Matching, Combinatorial Chemistry & High Throughput Screening 2017; 20 (7) . https://dx.doi.org/10.2174/1386207320666170417145856