J Gynecol Oncol.  2016 Mar;27(2):e20. 10.3802/jgo.2016.27.e20.

Outcomes of laparoscopic fertility-sparing surgery in clinically early-stage epithelial ovarian cancer

• Park JY
• Heo EJ
• Lee JW
• Lee YY
• Kim TJ
• Kim BG
• Bae DS

• KMID: 2360250
• DOI: http://doi.org/10.3802/jgo.2016.27.e20

Abstract

OBJECTIVE
Fertility-sparing surgery (FSS) is becoming an important technique in the surgical management of young women with early-stage epithelial ovarian cancer (EOC). We retrospectively evaluated the outcome of laparoscopic FSS in presumed clinically early-stage EOC.
METHODS
We retrospectively searched databases of patients who received laparoscopic FSS for EOC between January 1999 and December 2012 at Samsung Medical Center. Women aged < or =40 years were included. The perioperative, oncological, and obstetric outcomes of these patients were evaluated.
RESULTS
A total of 18 patients was evaluated. The median age of the patients was 33.5 years (range, 14 to 40 years). The number of patients with clinically stage IA and IC was 6 (33.3%) and 12 (66.7%), respectively. There were 7 (38.9%), 5 (27.8%), 3 (16.7%), and 3 patients (16.7%) with mucinous, endometrioid, clear cell, and serous tumor types, respectively. Complete surgical staging to preserve the uterus and one ovary with adnexa was performed in 4 patients (22.2%). Two out of them were upstaged to The International Federation of Gynecology and Obstetrics stage IIIA1. During the median follow-up of 47.3 months (range, 11.5 to 195.3 months), there were no perioperative or long term surgical complications. Four women (22.2%) conceived after their respective ovarian cancer treatments. Three (16.7%) of them completed full-term delivery and one is expecting a baby. One patient had disease recurrence. No patient died of the disease.
CONCLUSION
FSS in young patients with presumed clinically early-stage EOC is a challenging and cautious procedure. Further studies are urgent to determine the safety and feasibility of laparoscopic FSS in young patients with presumed clinically early-stage EOC.

Keyword

Fertility-Sparing Surgery; Laparoscopy; Ovarian Epithelial Cancer

MeSH Terms

Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Female
*Fertility Preservation
Humans
Laparoscopy
Live Birth
Neoplasm Recurrence, Local/blood/diagnosis/*therapy
Neoplasm Staging
Neoplasms, Glandular and Epithelial/drug therapy/*pathology/*surgery
*Organ Sparing Treatments
Ovarian Neoplasms/drug therapy/*pathology/*surgery
Pregnancy
Pregnancy Rate
Retrospective Studies
Term Birth
Treatment Outcome
Young Adult