Fertility preservation in patients with early epithelial ovarian cancer

Abstract

Objective: To assess the role of fertility preservation in the treatment of patients with early epithelial ovarian cancer (EOC). Methods: We retrospectively analyzed the medical records of 21 patients with early EOC from January 1995 to December 2006. All eligible patients with a strong desire to preserve fertility were younger than 35 years and underwent fertility-sparing surgery with or without adjuvant chemotherapy. Results: Twenty-one eligible patients with a median age of 26.7 years (range, 20 to 33 years) were identified, and the mean follow-up period was 43 months (range, 5 to 86 months). Only one patient with stage IC recurred 34 months after the first operation. A total of five patients were able to become pregnant at least once after the first fertility preserving treatment, with or without adjuvant chemotherapy. All five patients succeeded in full-term vaginal delivery with healthy infants. No patients died of their disease. Conclusion: Fertility preserving treatment in patients with early EOC can be considered as a proper treatment strategy in patients with early EOC, who have the strong desire for fertility preservation.

Fertility-Sparing Surgery in Ovarian Cancer: A Systematic Review

“…The tumor type distribution showed a substantial variation between studies (e.g. mucinous tumors ranging from 36.2% [28] to 76.2% [25]).…”

“…The administration of adjuvant chemotherapy varied between studies: Whereas in some studies all patients received chemotherapy with a regimen depending on the stage/grade and/or completeness of surgical staging [19,29], other authors reported chemotherapy in a varying percentage of patients depending on the tumor stage and biological criteria [13,16,22,23,25,26] or without clear criteria of indication [12,20,21,24,31,32] (table 1). …”

“…A total of 15 studies [12,13,16,19,20,21,22,23,24,25,26,27,28,29,30] comprising 913 patients (11-43 years of age) met the inclusion criteria. In terms of assignability of recurrences to stage and grade, the cumulative analysis of data from 4 studies [13,20,22,30] published by Marpeau et al 2008 [31] contained more detailed information than some of the original publications and was therefore employed for the meta-analysis.…”

Fertility-Sparing Surgery for Young Women with Early-Stage Epithelial Ovarian Cancer

“…The safety of fertility-sparing surgery in women with stage IC and grade 3 EOC has not been determined, although the results of several recent series have suggested that fertility-sparing surgery is safe in patients with stage IC grade 1-2 EOC, regardless of the type of stage 1C (positive peritoneal cytology, capsule invasion or tumor rupture) [19,20,23,25,28,29,32,33,34,35,36,37,38,39]. Patients with preoperative or intraoperative tumor rupture, surface excrescences, or malignant cells in ascitic fluid or peritoneal washings are classified as having stage IC disease.…”

“…In most studies, including this review, fertility-sparing surgery has been defined as the preservation of ovarian tissue in one or both adnexa and the uterus in women of reproductive age [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39] (table 1). To date, 918 patients with EOC who underwent fertility-sparing surgery have been captured in the literature.…”