Endometrium Kanserinde Over Tutulumunu Etkileyen Klinik ve Patolojik Faktörlerin İncelenmesi

Abstract

Batur HM, The Investigation of Clinical and Pathological Factors Related to Ovarian Involvement in Endometrial Cancer, Hacettepe University Faculty of Medicine, Thesis in Obstetrics and Gynecology, Ankara 2019. Endometrial adenocarcinoma which is the most common gynecologic cancer is surgically staged. This staging includes total hysterectomy with bilateral salpingo-oophorectomy regardless of age. In premenopausal women with endometrial adenocarcinoma, oophorectomy leads to some adverse effects which are associated with poor quality of life. Therefore, ovarian preservation cocept has recently emerged in premenopausal endometrial adenocarcinoma patients especially in those with early stage disease. Several studies have shown that such approach does not adversely impact the oncologic prognosis. This study aimed to restrospectively investigate the clinical and pathological characteristics of patients with ovarian metastasis who were subjected to surgery with a diagnosis of endometrial adenocarcioma at Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology between the years 2000-2016. The study group consisted of 725 patients and 76 (10.5%) of these patients were premenopausal. Ovarian metastasis was detected in only 66 (9.1%) of the patients. 39 patients younger than 45 years of age with grade 1-2, endometrioid type disease without deep myometrial invasion were detected in the study group who are considered to be acceptable for ovarian preservation according to literature. Ovarian metastasis was detected in none of these patients. Also, lymphovascular space invasion and cervical involvement were found to be associated with ovarian metastasis especially in early stage disease. In conclusion, bilateral oophorectomy is not necessary in all patients with a diagnosis of endometrial adenocarcinoma. Ovarian preservation does not impact the oncologic prognosis adversely in selected patients and it can improve the quality of life of these patients by precluding the short and long-term problems caused by estrogen deprivation. Such an approach may be considered for patients younger than 45 years of age with grade 1-2, endometrioid type endometrial adenocarcinoma without deep myometrial invasion, lymphovascular space invasion or cervical involvement who have normal-appearing ovaries and no gross extrauterine disease during the surgery. Key Words: Endometrial cancer, Endometrial adenocarcinoma, Ovarian metastasis, Oophorectomy, Ovarian preservation.