title: Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer.
abstract: BACKGROUND
  The objective of this study is to evaluate the safety of fertility-sparing surgery (FSS) for early-stage epithelial ovarian cancer (EOC).
  
  
  METHODS
  A retrospective analysis was performed to identify patients treated for early-stage EOC and to compare the clinical outcomes of patients treated with FSS and radical surgery (RS).
  
  
  RESULTS
  A total of 1031 patients were treated at two Institutions, 242 with FSS (group A) and 789 with RS (group B). Median duration of follow-up was 11.9 years. At univariate analyses, FSS was associated with decreased risk of relapse (P=0.002) and of tumour-related death (P=0.001). Multivariate analysis did not confirm the independent positive role of FSS neither on relapse-free interval (RFI) nor on cancer-specific survival (CSS). Tumour grade was associated with shorter RFI (P<0.001) and shorter CSS (P=0.001). The type of treatment did not influence CSS or RFI in any grade group. We also found a significant association between low-grade tumours and younger age.
  
  
  CONCLUSIONS
  Fertility-sparing surgery is an adequate treatment for patients with stage I EOC. The clinical outcome of patients with G3 tumours, which is confirmed to be the most important prognostic factor, is not determined by the type of treatment received.
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.|Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.
authors.forename: Robert
authors.initials: R
authors.lastname: Fruscio
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.|Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ceppi
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Corso
authors.affiliation: Laboratory of Methodology for Clinical Research, Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Via La Masa 19, Milan 20156, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Galli
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Dell'Anna
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.|Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Dell'Orto
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.|Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Giuliani
authors.affiliation: Division of Gynecologic Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Garbi
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Chiari
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.|Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Mangioni
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.|Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
authors.affiliation: Laboratory of Methodology for Clinical Research, Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Via La Masa 19, Milan 20156, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Floriani
authors.affiliation: Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy.|Division of Gynecologic Oncology, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Colombo
authors.affiliation: Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Via Pergolesi 33, Monza 20900, Italy.
authors.forename: Cristina Maria
authors.initials: CM
authors.lastname: Bonazzi
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007247:Infertility, Female / Q000209:etiology; D008197:Lymph Node Excision; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009852:Omentum / Q000601:surgery; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D010052:Ovariectomy / Q000009:adverse effects / Q000379:methods*; D010537:Peritoneum / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D058994:Salpingectomy / Q000009:adverse effects
chemical_list: D018906:Antineoplastic Agents, Alkylating; D009944:Organoplatinum Compounds