Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

Arnold-Jan Kruse*, Henk G. ter Brugge, Harm H. de Haan, Hugo W. Van Eyndhoven, Hans W. Nijman

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Objective Vaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.

Methods Medline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.

Results Of the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89-94.5% and 86-97.8%, respectively).

Conclusion Bilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.

Original languageEnglish
Pages (from-to)299-304
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume29
Issue number2
DOIs
Publication statusPublished - Feb 2019

Keywords

  • endometrial cancer
  • comorbidity
  • vaginal hysterectomy
  • salpingo-oophorectomy
  • COEXISTING OVARIAN MALIGNANCY
  • PREMENOPAUSAL WOMEN
  • ABDOMINAL HYSTERECTOMY
  • YOUNG-WOMEN
  • PRESERVATION
  • SAFETY
  • ADENOCARCINOMA
  • MANAGEMENT
  • OUTCOMES

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