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Fertility sparing surgery in early stage epithelial ovarian cancer.

Ditto A, Martinelli F, Lorusso D, Haeusler E, Carcangiu M, Raspagliesi F - J Gynecol Oncol (2014)

Bottom Line: No deaths were reported.Thirteen out of 18 (72.2%) attempted to have a pregnancy.Five (38%) achieved a spontaneous pregnancy with a full term delivery.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. antonino.ditto@istitutotumori.mi.it.

ABSTRACT

Objective: Fertility sparing surgery (FSS) is a strategy often considered in young patients with early epithelial ovarian cancer. We investigated the role and the outcomes of FSS in eEOC patients who underwent comprehensive surgery.

Methods: From January 2003 to January 2011, 24 patients underwent fertility sparing surgery. Eighteen were one-to-one matched and balanced for stage, histologic type and grading with a group of patients who underwent radical comprehensive staging (n=18). Demographics, surgical procedures, morbidities, pathologic findings, recurrence-rate, pregnancy-rate and correlations with disease-free survival were assessed.

Results: A total of 36 patients had a complete surgical staging including lymphadenectomy and were therefore analyzed. Seven patients experienced a recurrence: four (22%) in the fertility sparing surgery group and three (16%) in the control group (p=not significant). Sites of recurrence were: residual ovary (two), abdominal wall and peritoneal carcinomatosis in the fertility sparing surgery group; pelvic (two) and abdominal wall in the control group. Recurrences in the fertility sparing surgery group appeared earlier (mean, 10.3 months) than in radical comprehensive staging group (mean, 53.3 months) p<0.001. Disease-free survival were comparable between the two groups (p=0.422). No deaths were reported. All the patients in fertility sparing surgery group recovered a regular period. Thirteen out of 18 (72.2%) attempted to have a pregnancy. Five (38%) achieved a spontaneous pregnancy with a full term delivery.

Conclusion: Fertility sparing surgery in early epithelial ovarian cancer submitted to a comprehensive surgical staging could be considered safe with oncological results comparable to radical surgery group.

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Related in: MedlinePlus

Disesase free survival (DFS) in two groups of patients with early epithelial ovarian cancer undergoing conservative (fertility sparing surgery, FSS) versus radical (radical comprehensive staging, RCS) treatment (Log-rank test, p=0.422; FSS: mean DFS 62.4 months, 95% confidence interval [CI], 48.7 to 76.2; RCS: mean DFS 89.1 months, 95% CI, 71.8 to 106.4).
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Figure 1: Disesase free survival (DFS) in two groups of patients with early epithelial ovarian cancer undergoing conservative (fertility sparing surgery, FSS) versus radical (radical comprehensive staging, RCS) treatment (Log-rank test, p=0.422; FSS: mean DFS 62.4 months, 95% confidence interval [CI], 48.7 to 76.2; RCS: mean DFS 89.1 months, 95% CI, 71.8 to 106.4).

Mentions: Among FSS patients, recurrences were distributed as follow: two in women with FIGO stage ≥IA grade 3 and 2 in patients with FIGO stage IA grade 1 to 2. The DFS curves did not show any significant difference between the two groups (p=0.422). No deaths were reported. The DFS was not statistically significant (Fig. 1).


Fertility sparing surgery in early stage epithelial ovarian cancer.

Ditto A, Martinelli F, Lorusso D, Haeusler E, Carcangiu M, Raspagliesi F - J Gynecol Oncol (2014)

Disesase free survival (DFS) in two groups of patients with early epithelial ovarian cancer undergoing conservative (fertility sparing surgery, FSS) versus radical (radical comprehensive staging, RCS) treatment (Log-rank test, p=0.422; FSS: mean DFS 62.4 months, 95% confidence interval [CI], 48.7 to 76.2; RCS: mean DFS 89.1 months, 95% CI, 71.8 to 106.4).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195303&req=5

Figure 1: Disesase free survival (DFS) in two groups of patients with early epithelial ovarian cancer undergoing conservative (fertility sparing surgery, FSS) versus radical (radical comprehensive staging, RCS) treatment (Log-rank test, p=0.422; FSS: mean DFS 62.4 months, 95% confidence interval [CI], 48.7 to 76.2; RCS: mean DFS 89.1 months, 95% CI, 71.8 to 106.4).
Mentions: Among FSS patients, recurrences were distributed as follow: two in women with FIGO stage ≥IA grade 3 and 2 in patients with FIGO stage IA grade 1 to 2. The DFS curves did not show any significant difference between the two groups (p=0.422). No deaths were reported. The DFS was not statistically significant (Fig. 1).

Bottom Line: No deaths were reported.Thirteen out of 18 (72.2%) attempted to have a pregnancy.Five (38%) achieved a spontaneous pregnancy with a full term delivery.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. antonino.ditto@istitutotumori.mi.it.

ABSTRACT

Objective: Fertility sparing surgery (FSS) is a strategy often considered in young patients with early epithelial ovarian cancer. We investigated the role and the outcomes of FSS in eEOC patients who underwent comprehensive surgery.

Methods: From January 2003 to January 2011, 24 patients underwent fertility sparing surgery. Eighteen were one-to-one matched and balanced for stage, histologic type and grading with a group of patients who underwent radical comprehensive staging (n=18). Demographics, surgical procedures, morbidities, pathologic findings, recurrence-rate, pregnancy-rate and correlations with disease-free survival were assessed.

Results: A total of 36 patients had a complete surgical staging including lymphadenectomy and were therefore analyzed. Seven patients experienced a recurrence: four (22%) in the fertility sparing surgery group and three (16%) in the control group (p=not significant). Sites of recurrence were: residual ovary (two), abdominal wall and peritoneal carcinomatosis in the fertility sparing surgery group; pelvic (two) and abdominal wall in the control group. Recurrences in the fertility sparing surgery group appeared earlier (mean, 10.3 months) than in radical comprehensive staging group (mean, 53.3 months) p<0.001. Disease-free survival were comparable between the two groups (p=0.422). No deaths were reported. All the patients in fertility sparing surgery group recovered a regular period. Thirteen out of 18 (72.2%) attempted to have a pregnancy. Five (38%) achieved a spontaneous pregnancy with a full term delivery.

Conclusion: Fertility sparing surgery in early epithelial ovarian cancer submitted to a comprehensive surgical staging could be considered safe with oncological results comparable to radical surgery group.

Show MeSH
Related in: MedlinePlus