Laparoscopic fertility-sparing surgery for early stage ovarian cancer: a single-centre case series and systematic literature review

Abstract

BackgroundThere is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to analyze recurrence patterns and fertility outcome in a cohort of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging.MethodsWe conducted a retrospective analysis of prospectively collected data on all patients undergoing fertility-sparing laparoscopic staging procedures for presumed EOC at a single gynecologic oncology service. Oncologic safety and reproductive outcome were the main outcome measures. The pertinent literature is reviewed.ResultsThe study cohort consisted of 12 women. Cases included 5 invasive epithelial tumors and 7 nonepithelial tumors. The disease was reclassified to a higher stage in one woman. After a median follow up period of 38 months (range: 14–108), the overall survival was 100% and recurrence-free survival 90.9%. Five (100%) of patients who attempted pregnancy conceived spontaneously. Three of them had uneventful term pregnancy delivering healthy babies. The literature search yielded 62 cases of laparoscopic fertility conserving surgery for ovarian cancer. There were 4 (6.2%) recurrences. Cumulative pregnancy and live birth rate were not estimable as earlier publications lack essential data.ConclusionsLaparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.

Fertility sparing surgery vs radical surgery for epithelial ovarian cancer: a meta-analysis of overall survival and disease-free survival

“…However, we could not discern the influence of stage IC grade 3 tumors on the pooled HR for want of data. Previous small reviews on this subject have also reported similar results [28,29]. Adjuvant therapy (mostly chemotherapy) was found to improve disease free-survival with FSS in our analysis, but the results were just statistically significant with the upper limit of CI just crossing zero value (− 0.0071 to − 0.0001).…”

The Case of a Serous Borderline Ovarian Tumor in a 15-Year Old Pregnant Adolescent: Sonographic Characteristics and Surgical Management

“…Several series have shown that laparoscopic surgery for fertility-sparing procedures in malignant and borderline ovarian tumors is feasible and is associated with similar oncological outcomes compared with traditional open surgery and demolitive procedures. [21][22][23][24][25] In this case of a 15year-old patient, we obviously proposed fertility sparing with preservation of the affected ovary, as indicated by the newest guidelines by National Comprehensive Cancer Network on this specific issue. 22 We discussed for long in our multidisciplinary team about whether to perform or not monolateral adnexectomy in this case but in the end, we decided to comply with the available recommendations.…”

Video endoscopic surgery in the treatment of patients with early ovarian cancer

“…Частота конверсий, по данным ли-тературы, невелика и варьирует от 0,6 до 8,9%, необходи-мость в лапаротомии возникла у 7,4% больных, включен-ных в настоящее исследование. Основными причинами конверсий являются обнаружение диссеминации в ходе лапароскопической ревизии и выраженный спаечный процесс [17,18].…”