Fertility-sparing surgery in young women with mucinous adenocarcinoma of the ovary

Kajiyama, Hiroaki; Shibata, Kiyosumi; Mizuno, Mika; Nawa, Akihiro; Mizuno, Kimio; Matsuzawa, Katsuji; Kawai, Michiyasu; Hosono, Satoyo; Nagasaka, Tetsuro; Kikkawa, Fumitaka

doi:10.1016/j.ygyno.2011.04.016

Cited by 37 publications

(33 citation statements)

References 18 publications

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“…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). …”

Section: Resultsmentioning

confidence: 99%

Fertility-Sparing Surgery in Ovarian Cancer: A Systematic Review

Bois

Heitz

Harter³

2013

Oncol Res Treat

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Background: Ovarian cancer is rarely diagnosed in women of reproductive age; however, this coincidence seems to increase due to changes in lifestyle. Available evidence on the prognostic impact of fertility-sparing surgery (FSS) is sparse, and there is an emerging need to consolidate such evidence. Materials and Methods: Systematic review of the literature, including testing for heterogeneity and meta-analytical odds ratio (OR) calculations. Results: 15 studies comprising 913 patients met the inclusion criteria for this review. Out of the 913 patients undergoing FSS, 11.4% developed recurrence during observation. Stage IB/C tumors were nearly twice as likely to recur as stage IA tumors (OR 1.72, 95% confidence interval (CI) 1.12-2.64, p < 0.05), and the risk of recurrence was 4 times higher in G2/3 compared to G1 tumors (4.26, 95% CI 2.31-7.86, p < 0.0001; and stage IC/G2/3 vs. stage IC/G1: OR 2.04, 95% CI 0.86-4.85, p > 0.05). A non-significant risk elevation was attributed to stage IC/G1 compared to stage IA/G1 (OR 1.48, 95% CI 0.66-3.16, p > 0.05). Conclusions: FSS with unilateral salpingo-oophorectomy is only advisable for unilateral grade 1 tumors. Further studies employing contemporary classification criteria, such as low- versus highgrade malignancies, a strictly standardized regimen of surgical staging, and meticulous reporting of recurrence localization, may help develop more differentiated recommendations.

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Section: Resultsmentioning

confidence: 99%

Fertility-Sparing Surgery in Ovarian Cancer: A Systematic Review

Bois

Heitz

Harter³

2013

Oncol Res Treat

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“…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.…”

Section: Text Of Reviewmentioning

confidence: 99%

“…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.…”

Section: Text Of Reviewmentioning

confidence: 99%

“…Advanced-stage mucinous EOC has been reported to be highly chemoresistant and more lethal than serous EOC [44,45,46,47]; however, the prognosis of patients with early-stage mucinous EOC is comparable to that of patients with serous EOC [48,49]. To date, only one study has specifically assessed the safety of fertility-sparing surgery in patients with mucinous EOC [37]. Although this was a small retrospective study, the outcomes of the 41 patients with stage I mucinous EOC who underwent fertility-sparing surgery were not inferior to those of the 107 patients treated with radical surgery.…”

Section: Text Of Reviewmentioning

confidence: 99%

“…Of the 918 patients captured from the literature, 613 (66.8%) underwent complete surgical staging (table 1). However, lymphadenectomy and appendectomy were optional procedures in four studies [26,28,29,36], and lymphadenectomy, omentectomy and appendectomy were optional staging procedures in three studies [34,35,37]. …”

Section: Text Of Reviewmentioning

confidence: 99%

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

Nam

2013

Gynecol Obstet Invest

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Background/Aims: To discuss the latest findings on oncologic and reproductive outcomes of fertility-sparing surgery in epithelial ovarian cancer (EOC) and to suggest proper indications for this treatment. Methods: A search of Medline database was performed for articles dealing with fertility-sparing surgery for EOC published in the English literature between January 1, 1969, and October 1, 2012. Results: To date, 918 patients with EOC underwent fertility-sparing surgery; 109 (11.9%) had disease recurrence and 48 (5.2%) died of disease. Retrospective studies suggest that fertility-sparing surgery may be safely performed in young women with a strong desire to preserve fertility and with nonclear cell histology, FIGO stage IA, IC and grade 1-2 disease or clear cell histology and FIGO stage IA disease. To date, 177 patients have succeeded in achieving 242 pregnancies, resulting in 214 term (88%) and 1 preterm (0.4%) births. Miscarriage rate was about 10% (25/242) and ectopic pregnancy rate was 0.8% (2/242) after fertility-sparing surgery. No congenital anomaly has been reported. Conclusions: Although randomized controlled trials have yet to be performed, many studies have suggested that fertility-sparing surgery is safe, with promising reproductive outcomes. Cautious selection of patients is important because of 5.2% mortality and 11% recurrence after this surgery.

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Impact of uterus‐preserving surgery on Stage I primary mucinous epithelial ovarian carcinoma: A multi‐institutional study with propensity score‐weighted analysis

Yoshihara

Kajiyama

Tamauchi

et al. 2020

Intl J Gynecology & Obste

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Objective To investigate the clinical characteristics of women with Stage I primary mucinous epithelial ovarian carcinoma (mEOC) and evaluate the impact of uterus‐preserving surgery (UPS) in terms of survival prognosis. Methods A regional multi‐institutional retrospective study conducted between January 1986 and March 2017 by reviewing records of the Tokai Ovarian Tumor Study Group. Clinical and pathologic data and survival outcomes were assessed for women with Stage I primary mEOC. The baseline imbalance between women with and those without UPS was adjusted by an inverse probability of treatment weighting method using the propensity score (PS) of independent clinical variables. Results Among 4730 women with malignant ovarian tumors, 185 had Stage I primary mEOC and were included in the study. The mean age was 47.6 years (range 12–87 years), and 56 (30.3%) women underwent UPS. After PS‐based adjustment, women in the UPS group did not have a poorer prognosis regarding overall survival (P=0.776) or recurrence‐free survival (P=0.683). Even after age stratification, there was no statistical difference in survival outcomes between the UPS and non‐UPS groups. Conclusion UPS was not associated with decreased survival and may be a treatment option for women with Stage I primary mEOC irrespective of age.

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Fertility-sparing surgery in young women with mucinous adenocarcinoma of the ovary

Cited by 37 publications

References 18 publications

Fertility-Sparing Surgery in Ovarian Cancer: A Systematic Review

Fertility-Sparing Surgery in Ovarian Cancer: A Systematic Review

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

Impact of uterus‐preserving surgery on Stage I primary mucinous epithelial ovarian carcinoma: A multi‐institutional study with propensity score‐weighted analysis

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