Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 6, pp 1103–1107 | Cite as

Ovarian metastasis in patients with endometrial cancer: risk factors and impact on survival

  • Tanja Ignatov
  • Holm Eggemann
  • Elke Burger
  • Olaf Ortmann
  • Serban Dan Costa
  • Atanas Ignatov
Original Article – Clinical Oncology



Oophorectomy is generally performed in patients with endometrial cancer despite the rate of ovarian metastasis being relatively low.

Patients and methods

A multicenter retrospective registry-based study was performed in 2329 patients with endometrial cancer. The outcome measures were the incidence of ovarian metastasis and the impact on overall survival.


Median follow-up was performed at 84 months. A total of 2158 women were eligible for analysis, of which 131 (6.1%) had ovarian metastasis. Women with ovarian metastasis were more likely to have > 50% myometrial invasion, undifferentiated nonendometrioid tumors, and lymph and vascular space invasion. The presence of < 50% myometrial invasion, endometrioid histology, well-differentiated cancer, and negative lymph and vascular space invasion were associated with a very low rate (0.5%) of ovarian metastasis. Notably, after matching for tumor histology and grade, myometrial invasion, and lymph and vascular space invasion, ovarian metastasis was not associated with a reduced median overall survival.


Ovarian preservation should be offered to premenopausal women with endometrial cancer in whom myometrial invasion is less than 50%, the histological type is endometrioid and well-differentiated, and lymph and vascular space invasion is not involved.


Endometrial cancer Ovarian Metastasis 



This study was not funded.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. In accordance with the statement of the Research and Ethical Committee of the Otto-von-Guericke University, Magdeburg, Germany, additional individual consent for this analysis was not needed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all patients before treatment. An additional individual consent for this analysis was not needed.


  1. Dumas L, Ring A, Butler J, Kalsi T, Harari D, Banerjee S (2016) Improving outcomes for older women with gynaecological malignancies. Cancer Treat Rev 50:99–108CrossRefPubMedPubMedCentralGoogle Scholar
  2. Eggemann H, Ignatov T, Kaiser K, Burger E, Costa SD, Ignatov A (2016) Survival advantage of lymphadenectomy in endometrial cancer. J Cancer Res Clin Oncol 142(5):1051–1060CrossRefPubMedGoogle Scholar
  3. Eggemann H, Ignatov T, Burger E, Costa SD, Ignatov A (2017) Management of elderly women with endometrial cancer. Gynecol Oncol 146(3):519–524CrossRefPubMedGoogle Scholar
  4. Gemer O, Bergman M, Segal S (2004) Ovarian metastasis in women with clinical stage I endometrial carcinoma. Acta Obstet Gynecol Scand 83(2):208–210CrossRefGoogle Scholar
  5. Hetu V, Petignat P, Wu Y, Drouin P, Sauthier P, Provencher D, Gauthier P (2009) Positive adnexal or uterine serosal involvement in stage IIIC endometrial cancer is an adverse factor for recurrence. Gynecol Obstet Invest 67(3):173–177CrossRefPubMedGoogle Scholar
  6. Larson CA (2011) Evidence-based medicine: an analysis of prophylactic bilateral oophorectomy at time of hysterectomy for benign conditions. Curr Oncol 18(1):13–15CrossRefPubMedPubMedCentralGoogle Scholar
  7. Lau HY, Twu NF, Yen MS, Tsai HW, Wang PH, Chuang CM, Wu HH, Chao KC, Chen YJ (2014) Impact of ovarian preservation in women with endometrial cancer. J Chin Med Assoc 77(7):379–384CrossRefPubMedGoogle Scholar
  8. Lee NK, Cheung MK, Shin JY, Husain A, Teng NN, Berek JS, Kapp DS, Osann K, Chan JK (2007) Prognostic factors for uterine cancer in reproductive-aged women. Obstet Gynecol 109(3):655–662CrossRefPubMedGoogle Scholar
  9. Modaress MG, Cheraghi F, Zamani N (2011) Ovarian metastasis in endometriod type endometrial cancer. Int J Fertil Steril 5(3):148–151Google Scholar
  10. Pellerin GP, Finan MA (2005) Endometrial cancer in women 45 years of age or younger: a clinicopathological analysis. Am J Obstet Gynecol 193(5):1640–1644CrossRefPubMedGoogle Scholar
  11. Takeshima N, Hirai Y, Yano K, Tanaka N, Yamauchi K, Hasumi K (1998) Ovarian metastasis in endometrial carcinoma. Gynecol Oncol 70(2):183–187CrossRefPubMedGoogle Scholar
  12. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, Initiative S (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457CrossRefGoogle Scholar
  13. Wright JD, Buck AM, Shah M, Burke WM, Schiff PB, Herzog TJ (2009) Safety of ovarian preservation in premenopausal women with endometrial cancer. J Clin Oncol 27(8):1214–1219CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gynecology and ObstetricsOtto-von-Guericke UniversityMagdeburgGermany
  2. 2.Institute of Biometry and Medical InformaticsOtto-von-Guericke UniversityMagdeburgGermany
  3. 3.Department of Gynecology and ObstetricsUniversity Medical Center RegensburgRegensburgGermany

Personalised recommendations