Ovary Removal May Not Be Needed in Endometrial Cancer

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A hysterectomy (surgical removal of the uterus), and often an oophorectomy as well, has been standard with this type of cancer, largely because of concerns that the cancer might also affect the ovaries and that continued production of estrogen could fuel tumor growth.

The study spanned the years 1988 to 2004 and ultimately involved 3,269 women age 45 or younger who had stage I endometrial cancer. All of the women were registered in a national cancer database.

All women had a hysterectomy, and the 12 percent who kept their ovaries tended to be younger, to have been diagnosed later in the span of the study, to have a low tumor grade and to live in the eastern United States.

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Removing the ovaries had virtually no effect on five-year survival rates, the study found. Among women who underwent the procedure, 98 percent of those with stage IA cancer, 96 percent who had stage IB disease and 89 percent with stage IC disease lived at least five years, compared with 98, 100 and 86 percent, respectively, of women who did not have their ovaries removed.

But even with oophorectomy dominating treatment for this type of cancer, individualization of treatment has been and should continue to be the standard, Fowler said.

Family history of cancer, stage and grade of the tumor and how aggressive the cancer is should all factor into treatment decisions, he said. So should the person's genetic vulnerability: Women carrying the BRCA cancer gene, for instance, probably have increased survival after undergoing ovary removal, he said.

"We need to individualize and discuss the risks and benefits," Fowler said.

More information

The U.S. National Cancer Institute has more on endometrial cancer.

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