medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Number 05

<< Back Next >>

Ginecol Obstet Mex 2022; 90 (05)

Value of fertility-sparing surgery for young females with epithelial ovarian cancer: a comparative study.

Abdelsalam WA, Etman W, Harb OA, Raafat AA, Balata R, Fathy AM

Language: English
References: 17
Page: 427-433
PDF size: 208.01 Kb.


ABSTRACT

Objective: In the current study, we aimed to compare between radical surgery and fertility saving surgery in females with stage 1A-C EOC regarding recurrence rate and patients survival rates in addition to evaluating reproductive and obstetric outcomes for stage I EOC females who were managed by fertility saving surgery.
Patients and Methods: We prospectively identified 60 patients diagnosed with stage I EOC aged ≤ 40 years. Patients in the fertility-preservation group underwent salpingo-oophorectomy on the side of the affected ovary in addition to incisional biopsy or wedge excision of the ovary on the other side. Patients in the radical surgery group underwent total hysterectomy and bilateral salpingo-oophorectomy. We followed up all patients for 5 years to assess their reproductive and oncological outcomes.
Results: Patients in the fertility preservation surgery group were significantly younger (30 ± 4 versus 35± 5) (p ‹ 0.001), their tumor sizes were smaller 3.4 ± 1.3 versus 6.0 ± 2.6 (p ‹ 0.001), of lower grade (p = 0.011), earlier stage (p ‹ 0.001) and has more mucinous histology than patients in the radical surgery group. There were no statistically significant differences between both groups regarding tumor recurrence or survival rates. Of 25 patients underwent fertility preservation surgery, 18/25 (72%) tried to get pregnant. 15/18 (83%) pregnancies were recorded, including 13 live births, 1 miscarriage, and 1 intrauterine fetal death.
Conclusion: Fertility sparing surgery could be adequate alternative to radical surgery for young females with stage I EOC.


REFERENCES

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018. https://doi.org/10.3322/ caac.21492

  2. Kajiyama H, Yoshihara M, Tamauchi S, Yoshikawa N, Suzuki S, Kikkawa F. Fertility-Sparing surgery for young women with ovarian endometrioid carcinoma: a multicenteric comparative study using inverse probability of treatment weighting European Journal of Obstetrics & Gynecology and Reproductive Biology: X 4 (2019). https://doi. org/10.1016/j.eurox.2019.100071

  3. Watanabe T, Soeda S, Nishiyama H, Kiko UY, Tokunaga H, Shigeta S, et al. Clinical and reproductive outcomes of fertility‑sparing surgery in stage I epithelial ovarian cancer. Molecular and Clinical Oncology 2020; 12: 44-50.

  4. Nasioudis D, Chapman-Davis E, Frey MK, Witkin SS, Holcomb K. Could fertility-sparing surgery be considered for women with early stage ovarian clear cell carcinoma? J Gynecol Oncol 2017; 28: e71. https://doi.org/10.3802/ jgo.2017.28.e71

  5. Eftekhar M, Pourmasumi S and Karimi-Zarchi M: Preservation of ovarian function during chemotherapy and radiotherapy in young women with malignancies. Iran J Reprod Med 2014; 12: 377‑82. PMID: 25071844

  6. Yin J, Wang Y, Shan Y, Li Y, Jin Y and Pan L: Pregnancy and oncologic outcomes of early stage low grade epithelial ovarian cancer after fertility sparing surgery: A retrospective study in one tertiary hospital of China. J Ovarian Res 2019; 12: 44. https://doi.org/10.1186/s13048-019-0520-6

  7. Morgan RJ, Armstrong DK, Alvarez RD, Bakkum-Gamez JN, Behbakht K, Chen LM, Copeland L, Crispens MA, DeRosa M, Dorigo O, et al: Ovarian cancer, version 1.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2016; 14: 1134-63. https://doi.org/10.6004/ jnccn.2016.0122

  8. Ledermann JA, Raja FA, Fotopoulou C, Gonzalez-Martin A, Colombo N and Sessa C; ESMO Guidelines Working Group: Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 (Suppl 6): vi24-vi32. https://doi.org/10.1093/annonc/mdt333

  9. Mandelbaum RS, Klar M, Takiuchi T, Bainvoll L, Matsuzaki S, Paulson R and Matsuo K. Fertility-sparing treatment for early-stage epithelial ovarian cancer: Contemporary oncologic, reproductive and endocrinologic perspectives J. Obstet. Gynaecol. Res. 2020; 46 (8): 1263-81. https:// doi.org/10.1111/jog.14302

  10. Fruscio R, Ceppi L, Corso S, Galli F, Dell'Anna T, Dell'Orto F, Giuliani D, Garbi A, Chiari S, Mangioni C, Milani R, Floriani I, Colombo N, et al. Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer. Br J Cancer 2016; 115: 641-8. https://doi.org/10.1038/bjc.2016.254

  11. Jiang X, Yang J, Yu M , Xie W , Cao D, Wu M, Pan L, Huang H, You Y and Shen K. Oncofertility in patients with stage I epithelial ovarian cancer: fertility-sparing surgery in young women of reproductive age World Journal of Surgical Oncology 2017; 15: 154. https://doi.org/10.1186/ s12957-017-1222-4

  12. Wright JD, Shah M, Mathew L, Burke WM, Culhane J, Goldman N, Schiff PB, Herzog TJ. Fertility preservation in young women with epithelial ovarian cancer. Cancer 2009; 115: 4118-26. https://doi.org/10.1002/cncr.24461

  13. Kajiyama H, Mizuno M, Shibata K, Yamamoto E, Kawai M, Nagasaka T, Kikkawa F. Recurrence-predicting prognostic factors for patients with early stage epithelial ovarian cancer undergoing fertility-sparing surgery: a multiinstitutional study. Eur J Obstet Gynecol Reprod Biol 2014; 175: 97-102. https://doi.org/10.1016/j.ejogrb.2014.01.014

  14. Ditto A, Martinelli F, Bogani G, Lorusso D, Carcangiu M, Chiappa V, Reato C, Donfrancesco C, De Carrillo KJ, Raspagliesi F. Long-term safety of fertility sparing surgery in early stage ovarian cancer: comparison to standard radical surgical procedures. Gynecol Oncol. 2015; 138: 78-82. https://doi.org/10.1016/j.ygyno.2015.05.004

  15. Satoh T, Tsuda H, Kanato K et al. A non-randomized confirmatory study regarding selection of fertility-sparing surgery for patients with epithelial ovarian cancer: Japan clinical oncology group study (JCOG1203). Jpn J Clin Oncol 2015; 45: 595-99. https://doi.org/10.1093/jjco/hyv032

  16. Bentivegna E, Fruscio R, Roussin S, Ceppi L, Satoh T, Kajiyama H, Uzan C, Colombo N, Gouy S, Morice P. Long-term follow-up of patients with an isolated ovarian recurrence after conservative treatment of epithelial ovarian cancer: review of the results of an international multicenter study comprising 545 patients. Fertil Steril 2015; 104: 1319-24. https://doi.org/10.1016/j.fertnstert.2015.06.008

  17. De Vos M, Smitz J, Woodruff TK. Fertility preservation in women with cancer. Lancet 2014; 384: 1302-10. https:// doi.org/10.1016/S0140-6736(14)60834-5




2020     |     www.medigraphic.com