title: Comprehensive study of ovarian metastases in young women with peritoneal pseudomyxoma: is a preservation of fertility possible?
abstract: OBJECTIVE
  To determine whether ovaries can be preserved in selected young women with peritoneal pseudomyxoma (PMP).
  
  
  BACKGROUND
  The traditional rule is to systematically perform a bilateral oophorectomy.
  
  
  METHODS
  A new policy was developed to preserve the ovaries when they are macroscopically normal in young women with PMP, strongly desiring a future pregnancy.
  
  
  RESULTS
  Thirty-three women younger than 41 years were selected after undergoing complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for PMP. A normal ovary was preserved in 6 of them, but in 6 of the 14 women who strongly desired a future pregnancy. Subsequently, ovarian preservation was only performed in cases of grade-1 PMP. Ovarian invasion was correlated with the grade (p < 0.05) and with the extent of peritoneal disease (p < 0.01). After a median follow-up of 54 months, none of the 6 women with preserved ovaries has developed an ovarian or a peritoneal recurrence. One woman became pregnant and egg harvesting and cryopreservation were performed for 4 women with a partially normal ovary.
  
  
  CONCLUSIONS
  This new policy allowed ovarian preservation in 43% of the young women desiring a future pregnancy and has already resulted in one birth. It exclusively concerned low-grade PMP. Recurrence in the preserved ovary was 0% with our selection criteria.
authors.affiliation: Department of Surgery, Institut Gustave Roussy, Villejuif, France. elias@igr.fr
authors.forename: D
authors.initials: D
authors.lastname: Elias
authors.forename: E
authors.initials: E
authors.lastname: Duchalais
authors.forename: A
authors.initials: A
authors.lastname: David
authors.forename: P
authors.initials: P
authors.lastname: Dartigues
authors.forename: P
authors.initials: P
authors.lastname: Duvillard
authors.forename: C
authors.initials: C
authors.lastname: Poirot
authors.forename: D
authors.initials: D
authors.lastname: Goéré
mesh_terms: D000293:Adolescent; D000328:Adult; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods; D010051:Ovarian Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D010052:Ovariectomy / Q000379:methods; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010537:Peritoneum / Q000601:surgery; D011247:Pregnancy; D011379:Prognosis; D011553:Pseudomyxoma Peritonei / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018570:Risk Assessment; D016019:Survival Analysis; D055815:Young Adult