Open Access

ARTICLE

Adjuvant Chemotherapy Necessity in Stage I Ovarian Endometrioid Carcinoma: A SEER-Based Study Verified by Single-Center Data and Meta-Analysis

Liang Yu^1,#, Mingrui Zhao^1,#, Jinhui Liu², Yuqin Yang¹, Lin Zhang², Wenjun Cheng^2,*

1 Department of Obstetrics and Gynecology, The First Clinical Medical College of Nanjing Medical University, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
2 Department of Gynecology, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, 210029, China

* Corresponding Author: Wenjun Cheng. Email:
# These two authors contributed equally to this work

Oncology Research 2025, 33(10), 3007-3022. https://doi.org/10.32604/or.2025.065137

Received 04 March 2025; Accepted 18 June 2025; Issue published 26 September 2025

Abstract

Background: The benefit of adjuvant chemotherapy for stage I ovarian endometrioid carcinoma (OEC) remains controversial. Hence, the study sought to explore its value in stage I OEC patients. Methods: Stage I OEC patients (1988–2018) were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox analysis was used to control confounders. Logistic regression was used to explore factors associated with adjuvant chemotherapy. Cox regression analysis and Kaplan-Meier curves were used to assess the survival benefits. Single-center clinical data and meta-analysis following PRISMA guidelines provided external validation. Result: Adjuvant chemotherapy correlated with improved survival (Hazard Ratio (HR): 0.860, p = 0.011), as did lymphadenectomy (HR: 0.842, p < 0.001). Higher age, pathological stage, and tumor grade negatively affected survival. Chemotherapy administration associated with higher pathological stage (IB: Odds Ratio (OR) 1.565, p < 0.001; IC: OR 4.091, p < 0.001), higher grade (G2: OR 2.336, p < 0.001; G3: OR 4.563, p < 0.001), and lymphadenectomy (OR 1.148, p = 0.040). Stratification analysis showed adjuvant chemotherapy failed to improve prognosis in stage IA/IB patients regardless of grade or lymphadenectomy. For stage IC patients, chemotherapy benefited grade 1-2 or grade 3 patients without lymphadenectomy, and grade 3 patients with lymphadenectomy. Meta-analysis revealed reduced recurrence in stage IC patients (OR = 0.50, p = 0.035). Conclusion: Adjuvant chemotherapy confers survival benefits for stage IC patients, particularly those without lymphadenectomy.

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Supplementary Material

Supplementary Material File

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