KCTBASE

Fertility sparing surgery in early stage epithelial ovarian cancer

Journal of Gynecologic Oncology 2014년 25권 4호 p.320 ~ p.327

(Ditto Antonino) - IRCCS National Cancer Institute Department of Gynecologic Oncology
(Martinelli Fabio) - IRCCS National Cancer Institute Department of Gynecologic Oncology
(Lorusso Domenica) - IRCCS National Cancer Institute Department of Gynecologic Oncology
(Haeusler Edward) - IRCCS National Cancer Institute Department of Anesthesiology
(Carcangiu Marialuisa) - IRCCS National Cancer Institute Department of Pathology
(Raspagliesi Francesco) - IRCCS National Cancer Institute Department of Gynecologic Oncology

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.