ArticleGynecologic oncology2019
Patterns of utilization and outcome of ovarian conservation for young women with minimal-risk endometrial cancer.
Article in Gynecologic oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 17 citations in OpenAlex.
- Influence of ovarian-sparing surgery and ovariectomy on prognosis in early cervical adenocarcinoma: a systematic review and meta-analysis.Gland surgery · 2022Article
- Conservative surgery for ovarian torsion in young women: perioperative complications and national trends.BJOG : an international journal of obstetrics and gynaecology · 2020Observational
- Minimally invasive surgery for early-stage ovarian cancer: Association between hospital surgical volume and short-term perioperative outcomes.Gynecologic oncology · 2020Article
- Association between hospital surgical volume and perioperative outcomes of fertility-sparing trachelectomy for cervical cancer: A national study in the United States.Gynecologic oncology · 2020Observational
- Hospital surgical volume and perioperative mortality of pelvic exenteration for gynecologic malignancies.Journal of surgical oncology · 2020Article
- Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer.Gynecologic oncology · 2019Article
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Authors and funding
7 authors at 2 institutions in 1 country.
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Abstract
objectiveTo profile patient characteristics associated with and outcomes of ovarian conservation at the time of hysterectomy in young women with minimal-risk endometrial cancer.
methodsA population-based retrospective analysis of the Nationwide Inpatient Sample between 2007 and 2015 was performed. Women aged <50 with minimal-risk endometrial cancer who had ovarian conservation (n = 2314) were compared to those who had oophorectomy (n = 8191). A classification-tree model with recursive partitioning analysis was constructed to examine patterns of ovarian conservation. Propensity score matching was performed and length of stay and perioperative complications were compared. Two validation cohorts were also analyzed in a similar fashion (benign gynecologic disease and cervical cancer).
resultsThere were nine distinct patterns of patient characteristics identified, and ovarian conservation rates ranged from 11.7% (women aged 40-49 who underwent abdominal hysterectomy at an urban teaching hospital) to 60.5% (non-obese women aged <40 with median household income ≥$63,000) (absolute difference, 48.8%, 95% confidence interval 39.9-57.7; P < 0.001). After propensity score matching, ovarian conservation was significantly associated with a decreased likelihood of hospitalization >2 days (relative risk reduction, 16.7%, P < 0.001). Rates of surgical complications were not different between the two groups (8.2% versus 8.3%, P = 0.91). In the benign gynecologic disease and cervical cancer cohorts, ovarian conservation was also associated with decreased length of hospitalization (all, P < 0.05).
conclusionThere is substantial variability in the utilization of ovarian conservation in young women with minimal-risk endometrial cancer based on patient, surgical, and hospital factors. Our study suggests that guidelines for ovarian conservation in this population would be helpful for improving patient selection and rates of ovarian conservation.
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