Prediction Of High-Risk Factors For Ovarian Metastasis In Patients With Endometrial Cancer: A large sample retrospective case-control study

Objective:  This study aimed to determine the high risk factors of ovarian metastasis of EC, to enable accurate evaluation of whether young EC patients can retain ovaries. Design: A large sample retrospective case-control study.Setting and population:All EC patients were treated and registered in the Liaoning Cancer Hospital between January 2006 and December 2017;aged 25-80 years. Methods: The study cohort was divided into two groups: EC patients with ovarian metastasis and without ovarian metastasis.To analyze ovarian metastasis on prognosis after propensity score matching (PSM) based on the stratified analysis of independent risk factors for ovarian metastasis.Main outcome measure:overall survival (OS) and progress free survival(PFS). Results:  A total of 1240 patients diagnosed with EC were eligible for analysis, of which 120 (9.7%) had ovarian metastasis. The EC patients with ovarian metastasis were more likely to have deep myometrial infiltration, lymph node metastasis and elevated CA125.Median follow-up time was 52 months (13-131 months); the median survival was 39 months in patients with ovarian metastasis and 111 months in those without ovarian metastasis (p＜0.001).Compared with EC patients without ovarian metastasis, the risk for death increased by 14.37 times in those with ovarian metastasis.According to the stratified analysis,PFS and OS of EC patients with ovarian metastasis in the low-risk group,and PFS of patients in the high-risk group were significantly shorter than those without ovarian metastasis (p＜0.0001,p=0.0034;p＜0.0001). Conclusion:  Deep myometrial invasion, lymph node metastasis and elevated CA125 were independent risk factors for ovarian metastasis of EC patients. Ovarian metastasis is an independent predictor of poor survival among EC patients.