Could fertility-sparing surgery be considered for women with early stage ovarian clear cell carcinoma?.
- Author:
Dimitrios NASIOUDIS
1
;
Eloise CHAPMAN-DAVIS
;
Melissa K FREY
;
Steven S WITKIN
;
Kevin HOLCOMB
Author Information
- Publication Type:Original Article
- Keywords: Ovarian Neoplasms; Adenocarcinoma, Clear Cell; Fertility; Fertility Preservation
- MeSH: Adenocarcinoma, Clear Cell; Cohort Studies; Epidemiology; Female; Fertility; Fertility Preservation; Humans; Hysterectomy; Mortality; Ovarian Neoplasms; Patient Selection; Retrospective Studies
- From:Journal of Gynecologic Oncology 2017;28(6):e71-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The aim of the present retrospective population-based study was to investigate the oncologic impact of uterine and ovarian preservation (OP) in premenopausal women with stage IA or IC ovarian clear cell carcinoma (OCCC). METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was accessed and a cohort of surgically-staged premenopausal women (age <50 years) diagnosed with unilateral stage IA or IC OCCC was drawn. Based on site-specific surgery codes, women who did not undergo hysterectomy and/or bilateral salpingo-oophorectomy (BSO) were identified. Overall survival (OS) and cancer-specific survival (CSS) rates were calculated following generation of Kaplan-Meier curves; comparisons were made with the log-rank test. Multivariate Cox analysis was performed to control for possible confounders. RESULTS: A total of 741 premenopausal women who met the inclusion criteria were identified. Based on available information, rate of uterine preservation was 14.5% (96/663) while the rate of OP was 28.1% (71/253). Five-year CSS rates were 90.8% for women who did not undergo hysterectomy compared with 87.7% for those who did (p=0.290). Similarly, 5-year CSS rates in the OP and BSO groups were 92.6% and 85%, respectively (p=0.060). After controlling for disease sub-stage (IA vs. IC), uterine or OP was not associated with a worse overall or cancer-specific mortality. CONCLUSION: In the present cohort, uterine and OP did not have a negative impact on oncologic outcomes. Selection criteria for fertility-sparing surgery (FSS) could be expanded to include women with stage IA OCCC.
