Prognosis of patients who relapse after fertility-sparing surgery in epithelial ovarian cancer.
BACKGROUND
The prognosis for patients who develop a recurrence after fertility-sparing surgery for epithelial ovarian cancer (EOC) remains unclear. This is the first study to evaluate survival in patients who have developed a recurrence in this context.


METHODS
The outcomes of relapsed patients reported in the literature in the four main series of fertility-sparing surgery for EOC were reviewed and updated (where feasible).


RESULTS
Twenty-three of the 166 patients in the series were reported to have recurrent disease. The site of the recurrence was the peritoneum (+/- remaining ovary) in 17 patients, and distant in six patients. Twelve patients died of recurrent disease, two are still alive with persistent disease, eight are disease-free, and one is alive but her exact status is not known. Among eight patients (34%) with an isolated recurrence on the remaining ovary, two died and one was lost to follow-up.


CONCLUSIONS
In this carefully monitored population, including systematic radiological examinations, the rate of isolated recurrences on the spared ovary is low. Recurrence in these patients carries a poor prognosis. Such results suggest that initial selection of candidates for fertility-sparing surgery should be carefully defined to reduce the rate of recurrences that carry a poor prognosis.
Marpeau
Olivier
O
Institut Gustave Roussy, 39 rue Camille Desmoulins, Villejuif, France.
Schilder
Jeanne
J
Zafrani
Yaelle
Y
Uzan
Catherine
C
Gouy
Sebastien
S
Lhommé
Catherine
C
Morice
Philippe
P
D000328:Adult; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis