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 ◽  
...  

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.

2010 ◽  
Vol 28 (10) ◽  
pp. 1727-1732 ◽  
Author(s):  
Toyomi Satoh ◽  
Masayuki Hatae ◽  
Yoh Watanabe ◽  
Nobuo Yaegashi ◽  
Osamu Ishiko ◽  
...  

Purpose The objective of this study was to assess clinical outcomes and fertility in patients treated conservatively for unilateral stage I invasive epithelial ovarian cancer (EOC). Patients and Methods A multi-institutional retrospective investigation was undertaken to identify patients with unilateral stage I EOC treated with fertility-sparing surgery. Favorable histology was defined as grade 1 or grade 2 adenocarcinoma, excluding clear cell histology. Results A total of 211 patients (stage IA, n = 126; stage IC, n = 85) were identified from 30 institutions. Median duration of follow-up was 78 months. Five-year overall survival and recurrence-free survival were 100% and 97.8% for stage IA and favorable histology (n = 108), 100% and 100% for stage IA and clear cell histology (n = 15), 100% and 33.3% for stage IA and grade 3 (n = 3), 96.9% and 92.1% for stage IC and favorable histology (n = 67), 93.3% and 66.0% for stage IC and clear cell histology (n = 15), and 66.7% and 66.7% for stage IC and grade 3 (n = 3). Forty-five (53.6%) of 84 patients who were nulliparous at fertility-sparing surgery and married at the time of investigation gave birth to 56 healthy children. Conclusion Our data confirm that fertility-sparing surgery is a safe treatment for stage IA patients with favorable histology and suggest that stage IA patients with clear cell histology and stage IC patients with favorable histology can be candidates for fertility-sparing surgery followed by adjuvant chemotherapy.


2016 ◽  
Vol 27 (2) ◽  
Author(s):  
Jin-Young Park ◽  
Eun Jin Heo ◽  
Jeong-Won Lee ◽  
Yoo-Young Lee ◽  
Tae-Joong Kim ◽  
...  

2021 ◽  
Vol 19 (1) ◽  
pp. e16-e21
Author(s):  
Waleed M. Etman ◽  
◽  
Mohamed Fathy Abohashim ◽  
Ramadan M. Ali ◽  
Osama Abd-Elaziz ◽  
...  

Background: Epithelial ovarian cancer is increasingly often diagnosed in young females who wish to preserve their fertility. Fertilitypreserving surgeries, where conservation of the uterus and contralateral ovary was performed, might be beneficial for patients with stage I epithelial ovarian cancer, but their safety is still controversial. In the present study, we aimed to compare radical surgery and fertility-saving surgery in females with stage IA–C epithelial ovarian cancer for recurrence and survival rates, as well as to evaluate reproductive and obstetric outcomes for stage I epithelial ovarian cancer females who were managed with fertility-saving surgery. Materials and methods: We prospectively identified 60 patients aged ≤40 years who were diagnosed with stage I epithelial ovarian cancer. The patients in the fertility-preservation group underwent salpingo-oophorectomy on the side of the affected ovary in addition to incisional biopsy or wedge excision of the ovary on the other side. The patients in the radical surgery group underwent total hysterectomy and bilateral salpingo-oophorectomy. We followed up all patients for 5 years to assess their reproductive and oncological outcomes. Results: Patients in the fertility preservation surgery group were significantly younger (30 ± 4 versus 35 ± 5 years) (p < 0.001), their tumor sizes were smaller (3.4 ± 1.3 versus 6.0 ± 2.6 cm) (p < 0.001), of lower grade (p = 0.011), earlier stage (p < 0.001) and had more mucinous histology than patients in the radical surgery group. There were no statistically significant differences between both groups regarding tumor recurrence or survival rates. Of 25 patients who underwent fertility preservation surgery, 18 (72%) attempted to conceive. A total of 15/18 (83%) pregnancies were recorded, including 13 live births, 1 miscarriage, and 1 intrauterine fetal death. Conclusion: Fertility-sparing surgery could be an adequate alternative to radical surgery for young females with stage I epithelial ovarian cancer.


2021 ◽  
Vol 10 (18) ◽  
pp. 4235
Author(s):  
Geoffroy Canlorbe ◽  
Nathalie Chabbert-Buffet ◽  
Catherine Uzan

(1) Background: although most patients with epithelial ovarian cancer (EOC) undergo radical surgery, patients with early-stage disease, borderline ovarian tumor (BOT) or a non-epithelial tumor could be offered fertility-sparing surgery (FSS) depending on histologic subtypes and prognostic factors. (2) Methods: we conducted a systematic review to assess the safety and fertility outcomes of FSS in the treatment of ovarian cancer. We queried the MEDLINE, PubMed, Cochrane Library, and Cochrane (“Cochrane Reviews”) databases for articles published in English or French between 1985 and 15 January 2021. (3) Results: for patients with BOT, FSS should be offered to young women with a desire to conceive, even if peritoneal implants are discovered at the time of initial surgery. Women with mucinous BOT should undergo initial unilateral salpingo-oophorectomy, whereas cystectomy is an acceptable option for women with serous BOT. Assisted reproductive technology (ART) can be initiated in patients with stage I BOT if infertility persists after surgery. For patients with EOC, FSS should only be considered after staging for women with stage IA grade 1 (and probably 2, or low-grade in the current classification) serous, mucinous or endometrioid tumors. FSS could also be offered to patients with stage IC grade 1 (or low-grade) disease. For women with serous, mucinous or endometrioid high-grade stage IA or low-grade stage IC1 or IC2 EOC, bilateral salpingo-oophorectomy and uterine conservation could be offered to allow pregnancy by egg donation. Finally, FSS has a large role to play in patients with non- epithelial ovarian cancer, and particularly women with malignant ovarian germ cell tumors.


2014 ◽  
Vol 25 (4) ◽  
pp. 320 ◽  
Author(s):  
Antonino Ditto ◽  
Fabio Martinelli ◽  
Domenica Lorusso ◽  
Edward Haeusler ◽  
Marialuisa Carcangiu ◽  
...  

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