Similar articles

Abstract: Objective: To assess the clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma (EOC). Methods: A retrospective study of young EOC inpatients (≤40 years old) was performed during January 1994 and December 2010 in eight institutions. Results: Data were analyzed from 94 patients treated with fertility-sparing surgery with a median follow-up time of 58.7 months. As histologic grade increased, overall survival (OS) and disease-free survival (DFS) of patients receiving fertility-sparing surgery declined. Neither staging surgery nor laparoscopy of early stage EOC with conservative surgery had a significant effect on OS or DFS. Normal menstruation recommenced after chemotherapy in 89% of the fertility-sparing group. Seventeen pregnancies among twelve patients were achieved by the end of the follow-ups. Conclusions: fertility-sparing treatment for patients with EOC Stage I Grade 1 could be cautiously considered for young patients. The surgical procedure and surgical route might not significantly influence the prognosis. Standard chemotherapy is not likely to have an evident impact on ovarian function or fertility in young patients.

[1]Ayhan, A., Gultekin, M., Celik, N.Y., Dursun, P., Taskiran, C., Aksan, G., Yuce, K., 2007. Occult metastasis in early ovarian cancers: risk factors and associated prognosis. Am. J. Obstet. Gynecol., 196(1):81.e1-81.e6.

[2]Berman, M.L., 2003. Future directions in the surgical management of ovarian cancer. Gynecol. Oncol., 90(2):S33-S39.

[3]Borgfeldt, C., Iosif, C., Måsbäck, A., 2007. Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer. Eur. J. Obstet. Gynecol. Reprod. Biol., 134(1):110-114.

[4]Cho, Y.H., Kim, D.Y., Kim, J.H., Kim, Y.M., Kim, K.R., Kim, Y.T., Nam, J.H., 2006. Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors? Gynecol. Oncol., 103(3):878-882.

[5]Colombo, N., Chiari, S., Maggioni, A., Bocciolone, L., Torri, V., Mangioni, C., 1994. Controversial issues in the management of early epithelial ovarian cancer: conservative surgery and role of adjuvant therapy. Gynecol. Oncol., 55(3):S47-S51.

[6]Ding, Z.M., Xie, X., 2006. Conservation of the reproductive capability in treating the ovarian epithelium carcinoma. Chin. J. Pract. Gynecol. Obstet., 22(4):247-249 (in Chinese).

[7]DiSaia, P.J., 1989. Conservative management of the patient with early gynecologic cancer. CA Cancer J. Clin., 39(3):135-154.

[8]Duska, L.R., Chang, Y.C., Flynn, C.E., Chen, A.H., Goodman, A., Fuller, A.F., Nikrui, N., 1999. Epithelial ovarian carcinoma in the reproductive age group. Cancer, 85(12):2623-2629.

[9]FIGO, 1989. Annual report on the results of treatment in gynecologic cancer. Int. J. Gynaecol. Obstet., 28(2):189-193.

[10]Greenlee, R.T., Hill-Harmon, M.B., Murray, T., Thun, M., 2001. Cancer statistics. CA Cancer J. Clin., 51(1):15-36.

[11]Kajiyama, H., Shibata, K., Suzuki, S., Ino, K., Nawa, A., Kawai, M., Nagasaka, T., Kikkawa, F., 2010. Fertility-sparing surgery in young women with invasive epithelial ovarian cancer. Eur. J. Surg. Oncol., 36(4):404-408.

[12]Kottmeier, H.L., Gentil, F., Junqueira, A., 1968. Surgical Management: Conservative Surgery. UICC Monograph Series No. 11. Springer Verlag, New York, p.443-459.

[13]Ma, K., Wen, H.W., Liao, Q.P., 2010. Significance of systematic lymphadenectomy in patients with macroscopic stage I epithelial ovarian carcinoma. Chin. J. Clin. Obstet. Gynecol., 11(2):105-108 (in Chinese).

[14]Maltaris, T., Boehm, D., Dittrich, R., Seufert, R., Koelbl, H., 2006. Reproduction beyond cancer: a message of hope for young women. Gynecol. Oncol., 103(3):1109-1121.

[15]Maltaris, T., Seufert, R., Fischl, F., Schaffrath, M., Pollow, K., Koelbl, H., Dittrich, R., 2007. The effect of cancer treatment on female fertility and strategies for preserving fertility. Eur. J. Obstet. Gynecol. Reprod. Biol., 130(2):148-155.

[16]Morice, P., Wicart-Poque, F., Rey, A., El-Hassan, J., Pautier, P., Lhommé, C., Crevoisier, R., Haie-Meder, C., Duvillard, P., Castaigne, D., 2001. Results of conservative treatment in epithelial ovarian carcinoma. Cancer, 92(9):2412-2418.

[17]Morice, P., Leblanc, E., Rey, A., Baron, M., Querleu, D., Blanchot, J., Duvillard, P., Lhommé, C., Castaigne, D., Classe, J.M., et al., 2005. Conservative treatment in epithelial ovarian cancer: results of a multicentre study of the GCCLCC (Groupe des Chirurgiens de Centre de Lutte Contre le Cancer) and SFOG (Société Française d′Oncologie Gynécologique). Hum. Reprod., 20(5):1379-1385.

[18]Park, J.Y., Kim, D.Y., Suh, D.S., Kim, J.H., Kim, Y.M., Kim, Y.T., Nam, J.H., 2008. Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer: oncologic safety and reproductive outcomes. Gynecol. Oncol., 110(3):345-353.

[19]Satoh, T., Hatae, M., Watanabe, Y., Yaegashi, N., Ishiko, O., Kodama, S., Yamaguci, S., Ochiai, K., Takano, M., Yokota, H., et al., 2010. Outcomes of fertility-sparing surgery for stage I epithelial ovarian cancer: a proposal for patient selection. J. Clin. Oncol., 28(10):1727-1732.

[20]Schilder, J.M., Thompson, A.M., DePriest, P.D., Ueland, F.R., Cibull, M.L., Kryscio, R.J., Modesitt, S.C., Lu, K.H., Geisler, J.P., Higgins, R.V., et al., 2002. Outcome of reproductive age women with stage Ia or Ic invasive epithelial ovrian cancer treated with fertility-sparing therapy. Gynecol. Oncol., 87(1):1-7.

[21]Scrov, S.F., Scully, R.E., Sobin, L.H., 1973. Histological Typing of Ovarian Tumors. World Health Organization, Geneva, Switzerland.

[22]Seli, E., Tangir, J., 2005. Fertility preservation options for female patients with malignancies. Curr. Opin. Obstet. Gynecol., 17(3):299-308.

[23]Shimada, M., Kigawa, J., Kanamori, Y., Itamochi, H., Oishi, T., Minagawa, Y., Ishihara, K., Takeuchi, Y., Okada, M., Terakawa, N., 2005. Outcome of patients with early ovarian cancer undergoing three courses of adjuvant chemotherapy following complete surgical staging. Int. J. Gynecol. Cancer, 15(4):601-605.

[24]Vergote, I., de Brabanter, J., Fyles, A., Bertelsen, K., Einhorn, N., Sevelda, P., Gore, M.E., Kærn, J., Verrelst, H., Sjövall, K., et al., 2001. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet, 357(9251):176-182.

[25]Wright, J.D., Shah, M., Mathew, L., Burke, W.M., Culhane, J., Goldman, N., Schiff, P.B., Herzog, T.J., 2009. Fertility preservation in young women with epithelial ovarian cancer. Cancer, 115(18):4118-4126.

[26]Zanetta, G., Chiari, S., Rota, S., Bratina, G., Maneo, A., Torri, V., Mangioni, C., 1997. Conservative surgery for stage I ovarian carcinoma in women of childbearing age. Br. J. Obstet. Gynaecol., 104(9):1030-1035.

[27]Zeng, D.Y., Shen, K., Huang, H.F., Wu, M., Pan, L.Y., Yang, J.X., Lang, J.H., 2005. Analysis of prognostic factors of malignant ovarian tumor after fertility-preserving treatment. Natl. Med. J. China, 85(36):2562-2565 (in Chinese).