Obstetric Results after Fertility-Sparing Management of Non-Epithelial Ovarian Cancer

Abstract

Purpose: To assess the recurrence and birth rates among patients with non-epithelial ovarian cancer. Methods: The study included 146 patients with germ cell (GCT, n = 84) and sex cord-stromal tumors (SCST, n = 62), who underwent fertility-sparing surgery. Adjuvant chemotherapy was administered to 86 (58.9%) patients. Most cases (133 out of 146) were staged FIGO I. Results: The 5- and 10-year disease-free survival rates were 91% and 83%, respectively. The recurrence risk was not associated with tumor histology, stage or age. Twenty-four months after the treatment, the rate of recurrence was higher than the rate of childbearing. The childbearing rates kept rising after the treatment and exceeded the rate of recurrence after 2 years. The cumulative incidence rates of birth 36, 60 and 120 months after treatment were 13.24%, 20.75%, and 42.37%, respectively. Chemotherapy was not related to childbearing. The patients’ age was related to the chance of childbearing. Conclusions: The prognoses of GCT and SCST are similar. Close follow-ups along with contraception should be offered to women during the first two years after treatment due to the increased risk of recurrence. After this period, relapses are rare and women can safely become pregnant.

Insights into the Clinico-Epidemiological Aspects of Non-Epithelial Ovarian Tumor Emphasizing Diagnosis and Tailored Surgical Approach; a Single Institutional Retrospective Study

“…The mean age of patients with non-epithelial ovarian cancer was 45.5±16 years, with a median age of 58 (range 18 -76) years. Piatek et al (2023) reported a median age was 28 (range 17-40 years), while Yang et al (2018) reported a median age was 22 (range 8-37 years). In comparison to other studies, our results showed a higher median age.…”

“…However, in a more recent study by Piatek et al (2023), involving a larger sample size of 146, a much higher percentage of 94% received the BEP protocol, with a remarkable 97.7% of those patients achieving a complete response to the treatment among the 86 patients (58.9%) who received chemotherapy. The median follow-up duration in our study was 61 months, a result closely resembling the findings of Bol et al (2021), who reported a median follow-up of 59 months, and Piatek et al (2023), where the follow-up was 63.3 months. In contrast, another study by Yang et al (2018) reported an average (mean) follow-up of 72 months, which is similar to our study's 74 months.…”

“…This recurrence rate aligns with the findings of Johansen et al (2019), which reported a recurrence rate of 5% (4/73). However, Yang et al (2018) reported a higher recurrence rate of 11.5% (17/175) with a mean interval to recurrence of 37.8 months, and Piatek et al (2023) found a relapse rate of 11.6% (17/146). In the study by Bol et al (2021), 5.8% (6/102) of patients experienced relapse during the first 2 years.…”