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European Journal of Gynaecological Oncology  2020, Vol. 41 Issue (3): 391-395    DOI: 10.31083/j.ejgo.2020.03.5147
Original Research Previous articles | Next articles
The outcomes of fertility sparing surgery in epithelial ovarian cancer
Emine Karabuk1, Burak Karadag2(), Ceyda Karadag3, M. Faruk Kose4, M. Murat Naki4, E. Nilufer Guler5
1Department of Gynecologic Oncology, Acıbadem University, Atakent Hospital, Istanbul, Turkey
2Department of Obstetrics and Gynecology, Antalya Training and Research Hospital, Antalya, Turkey
3Department of Gynecologic Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
4Department of Gynecologic Oncology, Acıbadem University, Atakent Hospital, Istanbul, Turkey
5Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey
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Abstract  

Conservative surgery has long been discussed as a treatment option in women with ovarian cancer at reproductive age. However, current guidelines recommend conservative surgery only in selected patients. There is considerable interest on pregnancy and delivery rates after fertility-sparing surgery (FSS), with several ongoing studies on this subject. The aim of the present multi-center study was to evaluate survival and pregnancy outcomes in patients that underwent fertility-sparing surgery. This retrospective study included 19 patients who underwent fertility-sparing surgery due to invasive epithelial ovarian cancer between 2002 and 2014. The median duration of follow-up was 59.5 months (range 10-152 months). A total of 10 full-term pregnancies and 3 spontaneous abortions occurred in 7 patients (36.8%) following FSS. Ten patients (52.6%) underwent prophylactic surgery after a median period of 49 months (16-119 months), while 2 patients (10.5%) developed recurrent disease after prophylactic surgery. Accurate staging in patients with early stage epithelial ovarian cancer and regular follow-up has shown promising reproductive outcomes. In light of the current data, fertility-sparing surgery should be considered in selected patients with stage I epithelial ovarian cancer. There is still no consensus, however, on the selection criteria of eligible patients for fertility-sparing surgery.

Key words:  Epithelial ovarian cancer      Fertility-sparing surgery      Surgical staging     
Submitted:  07 January 2019      Accepted:  01 April 2019      Published:  15 June 2020     
*Corresponding Author(s):  Burak Karadag     E-mail:  drburakkaradag@gmail.com

Cite this article: 

Emine Karabuk, Burak Karadag, Ceyda Karadag, M. Faruk Kose, M. Murat Naki, E. Nilufer Guler. The outcomes of fertility sparing surgery in epithelial ovarian cancer. European Journal of Gynaecological Oncology, 2020, 41(3): 391-395.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2020.03.5147     OR     https://ejgo.imrpress.com/EN/Y2020/V41/I3/391

Table 1  - Clinical and histological characteristics of the patients.
Patient Age (year) Parity* Histology Grade Type of Surgery Stage
1 29 0 Endometrioid 1 USO + Omm + BPPALND 1A
2 26 0 Serous 2 USO + Omm + BPPALND + APP 1C
3 27 0 Endometrioid 2 USO + Omm + BPPALND 1A
4 24 1 Serous 1 USO + Omm + BPPALND + APP 1A
5 21 1 Endometrioid 1 USO 1A
6 33 0 Endometrioid 2 USO + Omm + BPPALND 1C
7 24 0 Mucinous 2 USO + Omm + BPPALND + APP 1A
8 29 0 Endometrioid 1 USO + Omm + BPPALND 1A
9 24 0 Mucinous 1 USO + Omm + PL 1A
10 18 0 Serous 1 USO + Omm + BPPALND 1A
11 38 0 Endometrioid 1 USO + Omm + BPPALND + APP 1A
12 27 0 Serous 1 USO + Omm + BPPALND + APP 1A
13 19 0 Mucinous 1 USO + Omm + BPPALND 1C
14 33 0 Serous 1 USO + Omm+BPPALND + APP 1A
15 27 1 Mucinous 1 USO + Omm 1A
16 30 1 Mucinous 1 USO + Omm + BPPALND + APP 1C
17 23 0 Mucinous 1 USO + Omm 1A
18 22 0 Endometrioid 1 USO + Omm + BPPALND 1C
19 37 0 Serous 1 USO + Omm + PL 1A
Table 2  - Operative and follow-up results of the patients.
Patient The number of pelvic lymph nodes removed The number of paraaortic lymph nodes removed The number of live birth after surgery Prophylactic surgery at x months Recurrence Follow-up(months)
1 19 2 - - no 13
2 21 20 - - yes 29
3 18 12 2 47 no 63
4 31 20 1 49 no 52
5 - - - - no 28
6 12 4 1 29 no 137
7 21 - - - no 43
8 30 5 - - no 28
9 9 - 2 62 no 120
10 10 5 - - no 45
11 24 12 - 37 no 59
12 19 9 1 - no 48
13 14 10 2 119 no 125
14 56 12 - 70 no 87
15 - - - - no 25
16 25 2 1 16 yes 43
17 - - - - no 25
18 25 10 - - no 10
19 11 5 - 59 no 152
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