title: Long-term follow-up of patients with an isolated ovarian recurrence after conservative treatment of epithelial ovarian cancer: review of the results of an international multicenter study comprising 545 patients.
abstract: OBJECTIVE
  To determine the long-term outcomes of patients with an isolated ovarian recurrence after fertility sparing surgery (FSS) for epithelial ovarian cancer (EOC) and to evaluate the recurrence rates (and location) according to the new 2014 International Federation of Gynecology and Obstetrics (FIGO) staging system.
  
  
  METHODS
  Retrospective multicenter study.
  
  
  METHODS
  Teams having reported recurrence after FSS for EOC.
  
  
  METHODS
  Four series comprising 545 patients undergoing FSS and 63 (12%) recurrences.
  
  
  METHODS
  FSS (salpingo-oophorectomy for a majority of cases) for EOC.
  
  
  METHODS
  Recurrences rates and characteristics of recurrent disease.
  
  
  RESULTS
  Among 63 recurrent patients, 24 (38%) recurrences were isolated on the spared ovary, and 39 (62%) arose at an extraovarian site. Among the patients with an isolated ovarian recurrence, three patients died after a median follow-up period of 186 months (range: 28-294 months). Among the patients with recurrent extraovarian disease, 24 died and 7 were alive with persistent disease after a median follow-up period of 34 months (range: 3-231 months). The overall rate of isolated ovarian and extrapelvic recurrences was higher for grade 3 tumors (compared with grades 1/2).
  
  
  CONCLUSIONS
  The long-term survival of patients with an isolated ovarian recurrence after FSS for EOC remains favorable. The prognosis of patients with an extraovarian recurrence is poor compared with those who have an isolated recurrent ovarian tumor. Grade 3 tumors (compared to grades 1/2) give rise to a higher rate of extraovarian recurrences.
authors.affiliation: Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France.
authors.forename: Enrica
authors.initials: E
authors.lastname: Bentivegna
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, University Milano-Bicocca, Milan, Italy.
authors.forename: Robert
authors.initials: R
authors.lastname: Fruscio
authors.affiliation: Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Roussin
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, University Milano-Bicocca, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ceppi
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Toyomi
authors.initials: T
authors.lastname: Satoh
authors.affiliation: Nagoya University Graduate School of Medicine, University of Nagoya, Nagoya, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kajiyama
authors.affiliation: Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France; Unit INSERM 30-10, Villejuif, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.affiliation: Department of Surgery and Interdisciplinary Medicine, University Milano-Bicocca, Milan, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Colombo
authors.affiliation: Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gouy
authors.affiliation: Department of Gynecologic Surgery, Institut Gustave Roussy, Villejuif, France; Unit INSERM 30-10, Villejuif, France; University Paris Sud, Paris, France. Electronic address: morice@igr.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
mesh_terms: D000293:Adolescent; D000328:Adult; D000077216:Carcinoma, Ovarian Epithelial; D005060:Europe; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D007564:Japan; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D058994:Salpingectomy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Conservative surgery; epithelial ovarian tumor; extraovarian recurrence; prognosis; recurrence