Fertility-sparing surgery in patients with clear-cell carcinoma of the ovary: is it possible?
BACKGROUND
Clear-cell carcinoma of the ovary (CCC) is often diagnosed at childbearing age, or sometimes during treatment for infertility. Therefore, most young women with early-stage CCC wish to preserve their reproductive and endocrine functions if possible.


METHODS
Clinicopathologic data collected under the central pathological review system were subjected to survival analyses. We analyzed patients with stage I CCC who underwent fertility-sparing surgery (FSS, n = 16) and compared their long-term survival with those receiving radical surgery (n = 205), or patients with non-CCC undergoing FSS (n = 64).


RESULTS
There was no difference in both the overall survival (OS) and disease-free survival (DFS) between patients with CCC who underwent FSS and those who received radical surgery [CCC/FSS (n = 16) versus CCC/radical (n = 205); OS: P= 0.519, DFS: P= 0.265]. Moreover, patients with CCC who underwent FSS did not show a poorer OS and DFS than non-CCC patients who underwent FSS (CCC/FSS versus non-CCC/FSS; OS: P= 0.584, DFS: P= 0.401), or those at the corresponding stage with no CCC. Furthermore, according to the series of patients with CCC in both the current study and four studies in the literature, there was no difference in the recurrence rate between patients with or without CCC who were treated conservatively (CCC/FSS: 13.2% versus non-CCC/FSS: 10.9%, P= 0.614).


CONCLUSIONS
Although our study did not have sufficient power to yield a definite conclusion, our data suggests that at least patients with stage IA CCC may be treated with FSS.
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan. kajiyama@med.nagoya-u.ac.jp
Hiroaki
H
Kajiyama
Kiyosumi
K
Shibata
Mika
M
Mizuno
Satoyo
S
Hosono
Michiyasu
M
Kawai
Tetsuro
T
Nagasaka
Fumitaka
F
Kikkawa
D000328:Adult; D000367:Age Factors; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate