Introduction/Background The aims of this study were to determine the frequency of ovarian involvement and to evaluate the impact of ovarian preservation on the recurrence and survival rates in premenopausal women when endometrioid endometrial cancer (EEC) was clinically confined to the uterus.

Methodology The medical records of premenopausal women under 50 years-old with EEC surgically treated at our institution between 2004 and 2017 were retrospectively reviewed. Patients were excluded if there were extrauterine diseases on imaging (pelvic MRI and PET-CT) or abnormal intraoperative gross findings around adnexa and/or other sites.

Results A total of 144 patients were found to have EEC clinically confined to the uterus, including 79 patients selectively preserving normal appearing ovaries. Ovarian preservation group was younger (p<0.01) and had significant associations with lower tumor grade (p=0.03) and lower prevalence of lymphadenectomy (p<0.01). Of 65 patients who underwent bilateral salpingo-oophorectomy, microscopic ovarian involvement was detected in only 1 patient, who had grade-3 tumor and deep myometrial invasion. In 79 patients with ovarian preservation, no recurrence at adnexa occurred. Ovarian preservation had no effect on either adnexa or other sites recurrence, and as well overall survival (median follow-up period: 67 months, range 13–133).

Conclusion Ovarian preservation may be considered in premenopausal women with low-risk endometrioid endometrial cancer clinically confined to the uterus, when there were normal appearing ovaries on preoperative evaluation and intraoperative exploration.

Disclosure Nothing to disclose.