title: Laparoscopic fertility-sparing surgery for early ovarian epithelial cancer: A multi-institutional experience.
abstract: OBJECTIVE
  There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to investigate the safety, adequacy and fertility outcome of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging using a multi-institutional sample.
  
  
  METHODS
  Prospectively collected data in five gynecologic oncology service databases were searched for epithelial EOC patients undergoing laparoscopic fertility-preserving surgery. Surgical, pathologic, oncologic and reproductive outcome data were analysed.
  
  
  RESULTS
  The study cohort consisted of 65 women. Median age of the patients was 33 (range: 21-42) years. In this cohort 36 (55.4%) and 29 (44.6%) patients were at low risk (FIGO stage IA G1-2) and high-risk (FIGO stage IA G3 or more), respectively. The disease was reclassified to a higher stage in 4 (6.1%) women. After a median follow up period of 38months (range: 2-144), the overall survival was 95.4% and recurrence-free survival 84.6%. Overall, there were 23 pregnancies in 22 women. After ovarian cancer treatment, 64.8% women reported pregnancy intent and 60% of these conceived spontaneously.
  
  
  CONCLUSIONS
  Laparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.
authors.affiliation: Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy. Electronic address: fabio.ghezzi@uninsubria.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.affiliation: Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.affiliation: Gynecologic Oncology Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti, Pescara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Advanced Gynecological Endoscopy Center, Malzoni Medical Center, Avellino, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Malzoni
authors.affiliation: Department of Gynecologic Oncology, IRCCS Foundation, National Cancer Institute, Milan, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Ditto
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
authors.forename: Pierandrea
authors.initials: P
authors.lastname: De Iaco
authors.affiliation: Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Department of Gynecologic Oncology, IRCCS Foundation, National Cancer Institute, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Raspagliesi
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery*; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
keywords: Early ovarian cancer; Gynecologic oncology; Laparoscopy; Surgical staging; Survival