Outcomes of ovarian preservation for women aged ≤50 years with stage I adenosarcoma undergoing hysterectomy

Objectives: Investigate the prevalence of ovarian preservation for women aged ≤ 50 years diagnosed with early stage adenosarcoma and its impact on overall survival. Methods: The National Cancer Database was accessed, and patients diagnosed between 2004 and 2015 with stage I adenosarcoma without a history of another tumor who underwent hysterectomy were identified. Clinico-pathological characteristics for patients who did and did not undergo bilateral salpingo-oophorectomy (BSO) were compared with the chi-square test. Overall survival was compared for patients who had at least one month of follow-up with the log-rank test and a Cox multivariate model was constructed to control for confounders. Results: A total of 367 patients with a median age of 42 were identified. In the present cohort, administration of chemotherapy (7.9%), radiation therapy (10.6%), and hormonal therapy (0.3%) was rare. BSO was performed for 311 (84.7%) patients. Patients who had BSO were older (median age 40.5 vs 43 years, p=0.011), and more likely to undergo lymphadenectomy (61.2% vs 34.5%, p Conclusions: For patients ≤ 50 years with early stage adenosarcoma ovarian preservation is rarely pursued. No detrimental effect on overall survival was observed. Thus ovarian preservation could be considered for carefully selected premenopausal patients.