Fertility sparing surgery in early stage epithelial ovarian cancer.
10.3802/jgo.2014.25.4.320
- Author:
Antonino DITTO
1
;
Fabio MARTINELLI
;
Domenica LORUSSO
;
Edward HAEUSLER
;
Marialuisa CARCANGIU
;
Francesco RASPAGLIESI
Author Information
1. Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. antonino.ditto@istitutotumori.mi.it
- Publication Type:Original Article ; Evaluation Studies ; Review
- Keywords:
Disease-free survival;
Fertility;
Lymph node excision;
Neoplasm recurrence;
Ovarian neoplasms;
Pregnancy
- MeSH:
Adult;
Female;
Fertility;
Fertility Preservation/*methods;
Humans;
Infertility, Female/prevention & control;
Lymph Node Excision;
Lymphatic Metastasis;
Middle Aged;
Neoplasm Recurrence, Local;
Neoplasm Staging;
Neoplasms, Glandular and Epithelial/pathology/*surgery;
Ovarian Neoplasms/pathology/*surgery;
Pregnancy;
Pregnancy Outcome;
Retrospective Studies;
Survival Analysis;
Treatment Outcome;
Young Adult
- From:Journal of Gynecologic Oncology
2014;25(4):320-327
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Fertility sparing surgery (FSS) is a strategy often considered in young patients with early epithelial ovarian cancer. We investigated the role and the outcomes of FSS in eEOC patients who underwent comprehensive surgery. METHODS: From January 2003 to January 2011, 24 patients underwent fertility sparing surgery. Eighteen were one-to-one matched and balanced for stage, histologic type and grading with a group of patients who underwent radical comprehensive staging (n=18). Demographics, surgical procedures, morbidities, pathologic findings, recurrence-rate, pregnancy-rate and correlations with disease-free survival were assessed. RESULTS: A total of 36 patients had a complete surgical staging including lymphadenectomy and were therefore analyzed. Seven patients experienced a recurrence: four (22%) in the fertility sparing surgery group and three (16%) in the control group (p=not significant). Sites of recurrence were: residual ovary (two), abdominal wall and peritoneal carcinomatosis in the fertility sparing surgery group; pelvic (two) and abdominal wall in the control group. Recurrences in the fertility sparing surgery group appeared earlier (mean, 10.3 months) than in radical comprehensive staging group (mean, 53.3 months) p<0.001. Disease-free survival were comparable between the two groups (p=0.422). No deaths were reported. All the patients in fertility sparing surgery group recovered a regular period. Thirteen out of 18 (72.2%) attempted to have a pregnancy. Five (38%) achieved a spontaneous pregnancy with a full term delivery. CONCLUSION: Fertility sparing surgery in early epithelial ovarian cancer submitted to a comprehensive surgical staging could be considered safe with oncological results comparable to radical surgery group.
