Surgery for endometrial cancer

Yiu-Tai Li, Sen-Wen Teng
2016 Taiwanese Journal of Obstetrics & Gynecology  
We read Lau and colleagues' report, entitled "Outcome of ovarian preservation during surgical treatment for endometrial cancer: a Taiwanese Gynecologic Oncology Group study", with interest [1] . This study was a multicenter retrospective study. The authors reported the outcome of 64 women diagnosed with endometrial cancer who had ovarian preservation. The results of the study showed that the 5-year recurrence-free survival rate was 98.3% and only one patient had documented local recurrence
more » ... cal recurrence during the median follow-up period of 44.6 months [1]. Then, the authors concluded that preservation of ovaries might not influence the outcome of patients with endometrial cancer and commented that a more conservative approach to surgical staging might be considered in premenopausal women with early-stage endometrial cancer without risk factors. We congratulated the success of this article; however, we have some questions and hope that the authors could kindly give a discussion. First, did the authors think that it is unnecessary to perform complete staging surgery in some of the women with endometrial cancer? Second, please clarify what the phrase "more conservative approach to surgical staging" means. Third, without performing complete staging surgery, how can the authors state that the patients with endometrial cancer were without any risk factors? If neither lymphadenectomy nor oophorectomy was performed in these patients, how can the authors make sure that these patients did not have metachronous ovarian malignancy or extrauterine spreading? Fourth, is the nonendometrioid cell type not a high-risk factor? In the authors' study, nearly 15% of patients had nonendometrioid cell type. Fifth, although the authors reported that eight patients received adjuvant therapy, could the authors clearly show the detailed information of these eight patients and comment on why these patients needed adjuvant therapy? In addition, two patients were treated with chemotherapy. Did these two patients have systemic diseases? We should claim that the abovementioned questions do not argue the value of this article. Conflicts of interest The authors have no conflicts of interest relevant to this article. Reference [1] Lau HY, Chen MY, Ke YM, Chen JR, Chen IH, Liou WS, et al. Outcome of ovarian preservation during surgical treatment for endometrial cancer: a Taiwanese Gynecologic Oncology Group study. Taiwan J Obstet Gynecol 2015;54:532e6.
doi:10.1016/j.tjog.2015.12.013 pmid:26927275 fatcat:24xrtsjpyndi7ppdlrk2vuiafi