Why for endometrial cancer is a bilateral salpingo-oophorectomy recommended along with a total hysterectomy?

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KevinHolcombMD (Physician - OBGYN - Gynecologic Oncology (Verified) ) - 07 / 24 / 2012

Removal of both tubes and ovaries is recommended for comprehensive staging of endometrial cancer for two reasons. The first reason is the concern for microscopic spread of tumor to the tubes or ovaries that would go undetected if the organs were left in place. The second concern is the potential stimulation of microscopic residual cancer cells by the continued estrogen production if the ovaries are retained. These risks are theoretical and prior studies suggest that both are low. One concern, however, is that the risk of a separate ovarian cancer at the time of the endometrial cancer diagnosis (termed a "synchronous ovarian tumor") is higher in younger women and can be as high as 30%. There is a growing literature suggesting the safety of retaining the ovaries in young women with low-grade endometrial cancers with minimal invasion of the uterine muscle, although further studies are needed to confirm this. This is an important finding as the incidence of endometrial cancer is increasing and approximately 10-15% will be diagnosed in premenopausal women.
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