Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer: oncologic safety and reproductive outcomes.
OBJECTIVE
Younger patients with invasive epithelial ovarian cancer (EOC) frequently want to preserve their fertility, but the role of fertility-sparing surgery in EOC has not been well defined. We therefore assessed tumor recurrence, patient survival and pregnancy outcomes in patients with invasive EOC who underwent fertility-sparing surgery.


METHODS
Records of 62 patients with invasive EOC who underwent fertility-sparing surgery, defined as the preservation of ovarian tissue in one or both adnexa and the uterus, between May 1990 and October 2006, were retrospectively reviewed.


RESULTS
Of the 62 EOCs, 36 were stage IA, 2 were stage IB, 21 were stage IC, and 1 each was stage IIB, IIIA, and IIIC; 48 were grade I, 5 were grade II, and 9 were grade III. Forty-eight patients received platinum-based adjuvant chemotherapy (mean 4.6 cycles, range 1-9 cycles). At a median follow-up of 56 months (range, 6-205 months), 11 patients had tumor recurrence, 6 died of disease, 2 were alive with disease, and 54 were alive without disease. Patients with stage >IC (p=0.0014) or grade III (p=0.0002) tumors had significantly poorer survival. Nineteen women attempted to conceive, and there were 22 term pregnancies, with no congenital anomalies in any of the offspring.


CONCLUSIONS
Fertility-sparing surgery can be considered in young patients with stages IA-C and grades I-II EOCs who desire to preserve their fertility.
Park
Jeong-Yeol
JY
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Kim
Dae-Yeon
DY
Suh
Dae-Shik
DS
Kim
Jong-Hyeok
JH
Kim
Yong-Man
YM
Kim
Young-Tak
YT
Nam
Joo-Hyun
JH
D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000328:Adult; D018269:Carcinoma, Endometrioid / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome