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Ovarian metastasis risk factors in endometrial carcinoma: A systematic review and meta-analysis

Published:November 12, 2021DOI:https://doi.org/10.1016/j.ejogrb.2021.11.016

      Abstract

      Objective

      To investigate the incidence of ovarian metastasis in endometrial carcinoma (EC) and analyze its risk factors and provide a theoretical basis for whether retention of the ovary in patients with EC.

      Methods

      A systematic search using synonyms of ‘ovarian cancer’ and ‘metastasis' was conducted in PubMed, Cochrane database, Embase, Google Scholar, and WOS database. Meta-analysis was performed on 7 included studies, comprising 4281 clinical-stage I-IV EC patients. Studies were assessed using the Newcastle–Ottawa Scale (NOS) criteria. Odds risks (OR) and 95% confidence intervals (CI) were calculated using an inverse variance weighted random-effects model.

      Results

      The ovarian metastasis risk of EC was significantly higher for patients with myometrial invasion >1/2 (OR = 18.19, 95% CI 5.34 to 61.96 compared to myometrial invasion ≤1/2), any pelvic lymph node invasion (PLNI) (OR = 5.41, 95% CI 2.60–10.97 compared to without PLNI), G3 pathological grade (OR = 2.66, 95%CI 1.35–5.24 compared to G1-G2), non-endometrioid pathological type (OR = 6.46, 95% CI 3.25 to 12.83 compared to endometrioid), lymphatic vascular space invasion (LVSI) (OR = 6.46, 95% CI 3.25 to 12.83 compare to without LVSI), age >45 (OR = 2.01, 95% CI 0.29 to 14.11 compared to age ≤45), and cervical invasion (OR = 4.12, 95% CI 1.87 to 9.08 compared to without cervical invasion).

      Conclusion

      About 4.95% of EC patients develop ovarian metastasis. Age >45, myometrial invasion >1/2, cervical invasion, PLNI, pathological type, G3 pathological grade, and LVSI were the high-risk factors for ovarian metastasis of EC. Ovarian preservation should be carefully selected for patients with EC, and preoperative and intraoperative evaluations should be entirely performed.

      Abbreviations:

      EC (endometrial carcinoma), MI (myometrial invasion), PLNI (pelvic lymph node invasion), LVSI (lymphatic vascular space invasion), OR (Odds risks), 95% CI (95% confidence intervals)

      Keywords

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