Oncological and Reproductive Outcomes of Fertility-sparing Surgery in Women with Early-stage Epithelial Ovarian Carcinom
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40(4):745-752,2020
745
Oncological and Reproductive Outcomes of Fertility-sparing Surgery in Women with Early-stage Epithelial Ovarian Carcinoma: A Multicenter Retrospective Study* Jing CHEN1†, Fen-fen WANG2†, Yan ZHANG1, Bin YANG1, Ji-hui AI3, Xin-yu WANG2, Xiao-dong CHENG2#, Ke-zhen LI1# 1 Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China 2 Department of Gynecologic Oncology, Women’s Hospital, Zhejiang University, Hangzhou 310006, China 3 Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Huazhong University of Science and Technology 2020
Summary: With delayed childbearing in women, preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma (EOC). Fertility-sparing surgery (FSS) can be considered in patients with early-stage disease in order to preserve fertility and improve quality of life. In order to evaluate oncological safety, attitudes toward childbearing and reproductive outcomes in women with EOC who underwent FSS, this multicenter retrospective study was conducted. Between January 2005 and December 2014, total of 87 young women with FIGO stage Ⅰ EOC were included, with their clinicopathologic parameters in relation to diseasefree survival (DFS) and overall survival (OS) assessed. Attitudes toward childbearing, ovarian function and fertility were studied in women undergoing FSS (n=36). As a result, in contrast to radical surgery, FSS did not affect prognosis by Kaplan-Meier curves (log-rank test; DFS: P=0.484; OS: P=0.125). However, two of the three recurrence cases and both death cases were in FSS group stage IC. All women undergoing FSS resumed regular menstrual periods after chemotherapy. Only 16 (44.44%) had tried to conceive, and 17 pregnancies occurred in 15 (93.75%) women. Among 20 women who did not attempt conception, the most common reason was not being married (70%), followed by already having children (15%). In summary, FSS is considered safe in young women with stage IA EOC. Regular menstruation and good obstetric outcomes can be achieved. This study also provides some insight into the attitudes and social factors regarding fertility in EOC patients. Key words: epithelial ovarian cancer; fertility outcome; fertility preservation; fertility sparing surgery; ovarian function
Epithelial ovarian cancer (EOC) is the second most common gynecological malignancy and represents the leading cause of death in women[1], comprising 75%– 90% of ovarian malignant tumors[2]. Although EOC occurs more frequently in the fifth and sixth decades of life, several studies reported that 3%–17% of all EOCs Jing CHEN, E-mail: [email protected]; Fen-fen WANG, E-mail: [email protected] † The authors contributed equally to this work. # Corresponding authors, Ke-zhen LI, E-mail; tjkeke@126. com; Xiao-dong CHENG, E-mail: [email protected] * This work was supported by National K
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