scholarly journals Sertoli-Leydig Cell Ovarian Tumors: Is Fertility or Endocrine-Sparing Surgery an Option upon Relapse?

2020 ◽  
Vol 13 (2) ◽  
pp. 935-940
Author(s):  
Stéphanie J. Seidler ◽  
Alexandre Huber ◽  
James Nef ◽  
Daniela E. Huber
Keyword(s):  
Leydig Cell ◽  
Early Stage ◽  
Young Patients ◽  
Hormonal Treatment ◽  
Conservative Surgery ◽  
Good Prognosis ◽  
Ovarian Tumors ◽  
Fertility Sparing ◽  
Bep Chemotherapy

Sertoli-Leydig cell ovarian tumors (SLCT) are rare ovarian tumors of the sex cord-stroma subset. Their incidence peaks in the second to third decade of life. Most SCLT are diagnosed at an early stage and have a good prognosis. Fertility-sparing surgery may thus be offered. Adjuvant chemotherapy may be indicated according to prognostic factors. However, outcome in relapsing SLCT is poor. There is no evidence supporting a best treatment option upon relapse, but most publications combine radical surgery, chemotherapy, and rarely radiotherapy. Two years after left adnexectomy for FIGO IA SLCT, a now 22-year-old patient presented with peritoneal recurrence without involvement of the remaining ovary and uterus. Since there is no evidence of a survival benefit in the literature of macroscopically healthy contralateral ovary ablation in relapse and hormonal replacement therapy is contraindicative, we consented to endocrine-sparing surgery with conservation of the contralateral ovary, followed by 3 cycles of BEP chemotherapy regimen. Our patient is disease-free 16 months after relapse diagnosis. Since recurrence of SLCT has a very poor prognosis and hormonal treatment is contraindicated, endocrine-sparing surgery for young patients with a normal contralateral ovary might be a legitimate option. This is one of the first reported cases of conservative surgery in SLCT recurrence, we therefore aimed to illustrate its management in a young patient with considerations of contraception, fertility- and then endocrine-sparing surgery, and quality of life.

Borderline ovarian tumors: A study of 100 cases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15069-15069
Author(s):  
C. E. Taner ◽  
M. Oztekin ◽  
S. Mun ◽  
S. Sehirali ◽  
C. Büyüktosun ◽  
...  
Keyword(s):  
Early Stage ◽  
Young Patients ◽  
Disease Free Survival ◽  
Conservative Surgery ◽  
Ovarian Tumors ◽  
Histopathological Diagnosis ◽  
Early Stage Disease ◽  
Borderline Ovarian Tumors ◽  
Stage Disease ◽  
Fertility Sparing

15069 Background: The purpose of the study was to evaluate the patients with borderline ovarian tumors. Methods: Clinical features, treatment and survival status of 100 patients with borderline ovarian tumors were retrospectively evaluated between 1998 and 2005. Results: Mean age was 37.75 (Range: 15–72) years. 22 cases were in postmenapausal status. Histopathological diagnosis was serous, musinous, endometrioid and clear cell in 54%, 41%, 2%, 3% of the patients, respectively. 19 cases underwent restaging laparotomy. In 52 cases fertility sparing surgery was performed. 70 patients had stage IA, 8 patients had stage IB, 16 cases had stage IC, 2 cases had stage IIIA, 3 cases cases had stage IIIB and a case had stage IIIC disease. 22 cases were administered chemotherapy because of advanced stage disease. All cases were alive. 5 year disease free survival of 51 cases was 100%. Conclusions: Borderline ovarian tumors have excellent prognosis and conservative surgery can be performed in young patients with early stage disease. No significant financial relationships to disclose.

Ovarian tumors of borderline malignancy: a review of 247 patients from 1991 to 2004

2007 ◽  
Vol 17 (2) ◽  
pp. 342-349 ◽  
Author(s):  
H. F. Wong ◽  
J. J.H. Low ◽  
Y. Chua ◽  
I. Busmanis ◽  
E. H. Tay ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Conservative Surgery ◽  
Figo Stage ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Time To Recurrence ◽  
Fertility Sparing ◽  
Significant Difference ◽  
Oncology Unit

Borderline ovarian tumors account for 15% of epithelial ovarian cancers and are different from invasive malignant carcinoma. Majority are early stage, occurring in women in the reproductive age group, where fertility is important. We reviewed retrospectively 247 such cases treated at the Gynaecological-Oncology Unit, KK Women's and Children's Hospital, between January 1991 and December 2004. The mean age was 38 years (16–89 years). Majority of the cases (92%) were FIGO stage I (Ia, 75%; Ib, 1%; and Ic, 16%). Seven (3.5%) patients were diagnosed as having stage II disease, six (2.5%) as stage IIIa, two (1%) as stage IIIb, and four (2%) as stage IIIc. Histological origin was as follows: mucinous (68%), serous (26%), endometrioid (2.6%), and clear cell (1.2%). Primary surgical procedures undertaken were as follows: hysterectomy with bilateral salpingo-oophorectomy (52%), unilateral salpingo-oophorectomy (33%), or ovarian cystectomy (15%). Adjuvant chemotherapy was administered in 13 patients (5.2% of cases), of which 4 patients were given chemotherapy only because of synchronous malignancies. There were six recurrences (2.4% of cases). Overall mean time to recurrence was 59 months. Recurrence rate for patients who underwent a primary pelvic clearance was 1.6% compared to fertility-sparing conservative surgery (3.3%; although P= 0.683). No significant difference was noted in recurrence and mortality between staged versus unstaged procedures. The overall survival rate was 98.0%. There were a total of five deaths (2.8%): three (1.5%) from invasive ovarian/peritoneal carcinoma and two from synchronous uterine malignancies. It appears that surgical resection is the mainstay of treatment, with conservative surgery where fertility is desired or pelvic clearance if the family is complete. Surgical staging is important to identify invasive extraovarian implants that portend an adverse prognosis. The role of adjuvant chemotherapy is not established.

scholarly journals Methods and conditions of fertility preservation in early-stage ovarian tumors

2013 ◽  
Vol 154 (14) ◽  
pp. 523-530
Author(s):  
Erzsébet Szatmári ◽  
Szabolcs Máté ◽  
Norbert Sipos ◽  
András Szánthó ◽  
Mihály Silhavy ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Fertility Preservation ◽  
Early Stage ◽  
Ovarian Tumors ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Stage Ia ◽  
Grade 3

The aim of this study is to review the literature of fertility-sparing techniques and their safety in early-stage malignant ovarian tumors, especially in epithelial ovarian cancer. Fertility preservation is widely accepted in early-stage borderline, germ cell and sex cord-stromal tumors. Based on data from retrospective studies, fertility-sparing surgery in epithelial ovarian cancer can be recommended in stage IA, grade 1–2 and favorable hystologic type ovarian cancer. Above stage IA, or in grade 3, or in clear-cell tumors decision making process about fertility-sparing surgery should be individual. Correct surgical staging is mandatory and oncologic safety should be primary. In the group of carefully selected patients oncological outcomes are identical to those of radical surgery. Spontaneous pregnancy rates vary, but they are generally high. Adequate counseling with patients, detailed documentation and careful follow-up is of outstanding importance. In order to improve the quality of fertility preservation techniques, establishment of treatment centers is recommended. Orv. Hetil., 2013, 154, 523–530.

Ultrasound in the follow-up of young patients with malignant ovarian tumors after conservative surgery

1994 ◽  
Vol 4 (1) ◽  
pp. 60-64 ◽  
Author(s):  
G. Zanetta ◽  
D. Trio ◽  
A. Lissoni ◽  
M. Pittelli ◽  
A. Di Lelio
Keyword(s):  
Young Patients ◽  
Conservative Surgery ◽  
Ovarian Tumors

scholarly journals Subcutaneous Quadrantectomy Is A Safe Procedure in Management of Early Stage Breast Cancer.

2021 ◽  
Author(s):  
Eva Lieto ◽  
Annamaria Auricchio ◽  
Silvia Erario ◽  
Giovanni Del Sorbo ◽  
Francesca Cardella
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Axillary Dissection ◽  
Early Stage ◽  
Length Of Hospital Stay ◽  
Oncologic Outcome ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer ◽  
Safe Procedure

Abstract Background: Surgical treatment of breast cancer, the most frequent cancer in women, is deeply changed in the last years turning towards a progressive minimally invasion, both in extend of demolition and in axillary dissection completeness. This is due to the flexibility of the concept of radicality that today is taylored on the patient, rather than on the disease; If oncologic radicality is preserved, a less invasive operation on the breast is mandatory. In the era of mini-invasive surgery, a patient may ask for an aesthetic care without any additional health risk.Methods: In this article, we compared two groups of 75 consecutive patients undergoing conservative surgery for early stage breast cancer; the two groups were randomized for standard quadrantectomy and totally subcutaneous quadrantectomy. Statistical analysis was carried out for comparing data.Results: No difference in oncologic outcome was found with the different surgical procedures; the length of hospital stay and the incidence of late breast deformities were significantly less in subcutaneous quadrantectomy group. Conclusions: We conclude that, in early breast cancer, a totally subcutaneous surgical procedure of resection is feasible and safe and ensures an absolutely better aesthetical result, that involves patient’s quality of life.

Early-Stage Cervical Cancer

2021 ◽  
pp. 139-157
Author(s):  
Maria Luisa Fais ◽  
Giorgio Candotti ◽  
Giulia Carboni ◽  
Speranza Luisa Anedda ◽  
Valerio Mais ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Stage ◽  
Reproductive Potential ◽  
Conservative Surgery ◽  
High Resource ◽  
Incidence And Mortality ◽  
Fertility Sparing ◽  
Early Stage Cervical Cancer ◽  
Lymph Node Assessment

Recent advances in screening and early diagnosis have decreased cervical cancer incidence and mortality rate in high-resource settings. The postponement of childbearing and the young age of women at diagnosis produced new challenges in the management of this disease. In recent years, attention has been directed to assessing more conservative procedures that can reduce treatment-related morbidity, without compromising oncologic safety and reproductive potential. Fertility sparing surgery (FSS) procedures, including cervical conization, simple or radical trachelectomy with pelvic nodes dissection or sentinel lymph node assessment, and neoadjuvant chemotherapy followed by conization, have shown encouraging results. In this chapter, the authors discuss the role of conservative surgery in the management of early-stage cervical cancer focusing on obstetrical and oncological outcomes.

scholarly journals Mastectomy versus conservative surgical treatment: the impact on the quality of life of women with breast cancer

2010 ◽  
Vol 10 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Daniela Francescato Veiga ◽  
Fabíola Soares Moreira Campos ◽  
Leda Marques Ribeiro ◽  
Ivanildo Archangelo Junior ◽  
Joel Veiga Filho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Functioning ◽  
Negative Impact ◽  
Young Patients ◽  
Conservative Surgery ◽  
Sf 36 ◽  
Significant Difference ◽  
The Impact

OBJECTIVES: to compare the impact of mastectomy and conservative surgery on the quality of life of patients with breast cancer. METHODS: an assessment was made of the quality of life of patients undergoing mastectomy or segmentary mastectomy, at the Pouso Alegre Clinical Hospital, in the Brazilian State of Minas Gerais, using SF-36. The patients were grouped by age (<50 years and >50 years) and years of schooling (<8 years and >8 years). The Mann-Whitney test was used to compare the groups with regard to the age and schooling domains of SF-36. RESULTS: a significant difference between the two groups was found in the domains of "physical functioning" (p=0.04) and "pain" (p=0.01): with the patients undergoing a mastectomy registering the worst scores. Young patients who had undergone a mastectomy displayed the worst quality of life in terms of "physical functioning" (p=0.03), "pain" (p=0.01) and "social functioning" (p=0.01); those undergoing conservative surgery aged over 50 years scored worst on "role emotional" (p=0.05). Patients undergoing a mastectomy with lower levels of schooling scored lower in "physical functioning" (p=0.01), "role physical" (p=0.05) and "pain" (p=0.05). Among those who had attended school for more than eight years, those having undergone a mastectomy scored less in the "pain" domain (p=0.04). CONCLUSIONS: patients who had undergone a mastectomy had worse results in the physical component of the evaluation of quality of life and this negative impact was more strongly felt among younger patients and those with lower levels of schooling.

Borderline ovarian tumors: Long-term survival and preservation of fertility.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15508-e15508
Author(s):  
Natasha Gercovich ◽  
Carlos Garcia Gerardi ◽  
Ernesto Gil Deza ◽  
Eduardo L. Morgenfeld ◽  
Edgardo G. J. Rivarola ◽  
...  
Keyword(s):  
Young Patients ◽  
Conservative Surgery ◽  
Ovarian Tumors ◽  
Population Characteristics ◽  
Borderline Tumor ◽  
Term Survival ◽  
Borderline Tumors ◽  
Borderline Ovarian Tumors ◽  
The Usa

e15508 Background: Borderline ovarian tumors, also called low-malignancy potential tumors, are infrequent tumors present predominantly in pre-menopause women. Their evolution after surgical treatment is generally very good. The main objective of this paper is to show the evolution of a group of borderline tumors treated at our institution. Methods: Between January 1, 2000 and January 1, 2010, 36 patients diagnosed with ovarian borderline tumors were examined by two independent pathologists, according to the guidelines established by the USA Association of Directors of Anatomic and Surgical Pathology. These patients were followed at IOHM and comprise this paper’s study group. Results: Population Characteristics: Mean Age: 41 years (Range: 20-85). Affected Ovary (Right: 17 pts; Left: 14 pts; Both: 5 pts). Pathology: Mucinous (17 pts), Serous (16 pts), Clear, Brenner and Endometroid Cells (1 pt each). Stages: IA (24 pts), IB (5 pts), IC (2pts), IIIA (4 pts), IIIC (1 pt). Five patients presented non-invasive peritoneal implants and three presented positive peritoneal liquid. All patients were surgically treated: 28 with total anexohisterectomy (TAH) and 8 with unilateral ooforectomy. No patient was given any chemotherapy or radiotherapy treatment. Four patients did not attend follow-up consultations and were lost after 4, 6, 12 and 29 months with no evidence of disease (NED). Thirty-two patients were followed bi-annually during the first five years and annually thereafter. One patient became pregnant after the surgery. All patients are alive and NED with an average follow up of 50 months (range: 29-133). Conclusions: 1) Although half the cases in the study were under 35 years old, there were 12 tumors present in patients over 50 years of age and 1 borderline tumor present in an 85 year old patient. 2) Surgically treated ovarian borderline tumors have a high chance of being curable without the need of chemotherapy or radiotherapy. 3) Conservative surgery in young patients allows a conservation of fertility, provided they are subject to an adequate follow-up.

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