title: Conservative management of early-stage epithelial ovarian cancer: results of a large retrospective series.
abstract: BACKGROUND
  To assess the long-term oncological outcome and the fertility of young women with early-stage epithelial ovarian cancer (ES/EOC) treated with fertility-sparing surgery (FSS).
  
  
  METHODS
  All patients treated with FSS for ES/EOC in two Italian centers were considered for this analysis. Univariate and multivariate analyses were used to test demographic characteristics and clinical features for the association with overall survival (OS), recurrence-free survival (RFS) and fertility.
  
  
  RESULTS
  From 1982 to 2010, 240 patients with malignant ES/EOC were treated with FSS in two tertiary centers in Italy. At a median follow-up of 9 years, 27 patients had relapsed (11%) and 11 (5%) had died of progressive disease. Multivariate analysis found only grade 3 negatively affected the prognosis of patients [hazard ratio (HR) for recurrence: 4.2, 95% confidence interval (CI): 1.5-11.7, P=0.0067; HR for death: 7.6, 95% CI: 2.0-29.3, P=0.0032]. Grade 3 was also significantly associated with extra-ovarian relapse (P=0.006). Of the 105 patients (45%) who tried to become pregnant, 84 (80%) were successful.
  
  
  CONCLUSIONS
  Conservative treatment can be proposed to all young patients when tumor is limited to the ovaries, as ovarian recurrences can always be managed successfully. Patients with G3 tumors are more likely to have distant recurrences and should be closely monitored.
authors.affiliation: Division of Obstetrics and Gynecology, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy. robilandia@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Fruscio
authors.forename: S
authors.initials: S
authors.lastname: Corso
authors.forename: L
authors.initials: L
authors.lastname: Ceppi
authors.forename: D
authors.initials: D
authors.lastname: Garavaglia
authors.forename: A
authors.initials: A
authors.lastname: Garbi
authors.forename: I
authors.initials: I
authors.lastname: Floriani
authors.forename: D
authors.initials: D
authors.lastname: Franchi
authors.forename: M G
authors.initials: MG
authors.lastname: Cantù
authors.forename: C M
authors.initials: CM
authors.lastname: Bonazzi
authors.forename: R
authors.initials: R
authors.lastname: Milani
authors.forename: C
authors.initials: C
authors.lastname: Mangioni
authors.forename: N
authors.initials: N
authors.lastname: Colombo
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis