How would you manage a patient with low-volume non-invasive endometrioid carcinoma that is found in both the endometrium and ovary (pN0)?

Isolated ovarian involvement in endometrial cancer is uncommon, and previous data from the Gynecologic Oncology Group and other single-institution series suggest that it occurs in less than 5% of patients. (Creasman et al. Cancer, 1987; Lin et al. Gynecol Oncol, 2015) Adnexal involvement when present, can also pose a diagnostic challenge for pathologists, because accurately discerning true metastatic disease from a synchronous primary can prove impossible using standard staining techniques. As a...

The data suggest most of these patients in absence of adverse factors are/behave like synchronous two primary rather than metastatic disease Sometimes LOH analysis can also help distinguish metastatses vs. two primary. Our approach in absence of adverse factor (deep myometrial involvement, LVSI) is to treat like two primaries and the published data suggests excellent outcome in these patients.

If IA grade 1 or 2, I would observe.