Table 2 Routine evaluation and Management protocol in our institute for synchronous endometrial and ovarian cancer for fertility preservation

Complete hemogram (Hemoglobin, total and differential leucocyte counts, platelet counts, erythrocyte sedimentation rate and C reactive protein)

Complete biochemistry (Renal, liver and thyroid function tests; serum calcium and phosphorus; serum electrolytes)

Tumour markers (alpha feto protein, carcinoembryonic antigen, CA-125, CA 19–9, Inhibin and Beta- human chorionic gonadotropin

Hormones: Luteinising hormone, follicle stimulating hormone and antimullerian hormone levels

Ultrasonography abdomen and pelvis/ contrast enhanced computed tomographic (CECT) of chest, abdomen and pelvis/ Gadolinium enhanced magnetic resonance imaging of abdomen/ pelvis

Hysteroscopic endometrial biopsy followed by histo-pathological examination

Fine needle aspiration cytology of ovarian mass based on radiological findings and operability

Fertility sparing surgery (unilateral salpingo-oophorectomy ± contralateral cystectomy) with preservation of uterus

High dose oral progestin (megestrol acetate, 160 mg) twice daily with or without Intravenous leuprolide acetate 3.75 mg once a month for six months;

Hysteroscopy biopsy and imaging at three monthly intervals for six months and thereafter at 3–6 months depending upon results of biopsy; In non-responders, completion surgery is performed

Chemotherapy (Carboplatin and paclitaxel) once every 3 weeks for 3–6 cycles

Follow up for ovarian cancer- CA 125 and CECT abdomen and pelvis once every three months

Further management based on results of follow up