Outcomes of Fertility-Sparing Surgery for Stage I Epithelial Ovarian Cancer: A Proposal for Patient Selection

Author:

Satoh Toyomi1,Hatae Masayuki1,Watanabe Yoh1,Yaegashi Nobuo1,Ishiko Osamu1,Kodama Shoji1,Yamaguchi Satoshi1,Ochiai Kazunori1,Takano Masashi1,Yokota Harushige1,Kawakami Yosuke1,Nishimura Sadako1,Ogishima Daiki1,Nakagawa Shunsuke1,Kobayashi Hiroaki1,Shiozawa Tanri1,Nakanishi Toru1,Kamura Toshiharu1,Konishi Ikuo1,Yoshikawa Hiroyuki1

Affiliation:

1. From the Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba; Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima; Department of Obstetrics and Gynecology, Tohoku University, Sendai; Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine; Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka; Department of Gynecology, Niigata Cancer Center Hospital, Niigata; Department of Gynecologic Oncology, Hyogo...

Abstract

Purpose The objective of this study was to assess clinical outcomes and fertility in patients treated conservatively for unilateral stage I invasive epithelial ovarian cancer (EOC). Patients and Methods A multi-institutional retrospective investigation was undertaken to identify patients with unilateral stage I EOC treated with fertility-sparing surgery. Favorable histology was defined as grade 1 or grade 2 adenocarcinoma, excluding clear cell histology. Results A total of 211 patients (stage IA, n = 126; stage IC, n = 85) were identified from 30 institutions. Median duration of follow-up was 78 months. Five-year overall survival and recurrence-free survival were 100% and 97.8% for stage IA and favorable histology (n = 108), 100% and 100% for stage IA and clear cell histology (n = 15), 100% and 33.3% for stage IA and grade 3 (n = 3), 96.9% and 92.1% for stage IC and favorable histology (n = 67), 93.3% and 66.0% for stage IC and clear cell histology (n = 15), and 66.7% and 66.7% for stage IC and grade 3 (n = 3). Forty-five (53.6%) of 84 patients who were nulliparous at fertility-sparing surgery and married at the time of investigation gave birth to 56 healthy children. Conclusion Our data confirm that fertility-sparing surgery is a safe treatment for stage IA patients with favorable histology and suggest that stage IA patients with clear cell histology and stage IC patients with favorable histology can be candidates for fertility-sparing surgery followed by adjuvant chemotherapy.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

Reference16 articles.

1. ACOG Practice Bulletin No. 83: Management of Adnexal Masses

2. Epithelial ovarian carcinoma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up

3. Ovarian Cancer Treatment Guidelines 2004 [in English] 22– 23,2005 Japan Society of Gynecologic Oncology Tokyo, Japan Kanehara

4. Ovarian Cancer Treatment Guidelines 2007 [in Japanese] 33– 35,2007 Japan Society of Gynecologic Oncology Tokyo, Japan Kanehara

5. Controversial Issues in the Management of Early Epithelial Ovarian Cancer: Conservative Surgery and Role of Adjuvant Therapy

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