Fertility-sparing surgery in young women with mucinous adenocarcinoma of the ovary

ObjectivesThe purpose of this study was to clarify the clinical outcome of patients with stage IA mucinous epithelial ovarian cancer (mEOC) treated with fertility-sparing surgery (FSS).MethodsAfter a central pathological review and search of the medical records from multiple institutions, a total of 148 stage I mEOC patients were retrospectively evaluated in the current study. All mEOC patients were divided into three groups: group A (FSS; age, 40≥); groups B and C {radical surgery; age, 40≥ (B); 40< (C)}. Survival analysis was performed among these three groups using Kaplan–Meier methods.ResultsThe median follow-up time of all mEOC patients was 71.6 (4.8–448.3) months. Among the 41 patients in group A, 27 patients (65.9%) had IA disease, and 14 (34.1%) had IC disease. Five-year overall survival (OS) and disease-free survival (DFS) rates of patients in the groups were as follows: group A, 97.3% (OS)/90.5% (DFS); group B, 94.4% (OS)/94.4% (DFS); group C; 97.3% (OS)/89.3% (DFS). Collectively, there was no significant difference in OS or DFS among these groups even though they were stratified to each substage (IA/IC) (OS, P = 0.180; DFS, P = 0.445, respectively). Furthermore, in multivariate analyses, the surgical procedure was not an independent prognostic factor for either OS or DFS (OS, HR: 0.340, 95% CI: 0.034–3.775, P = 0.352; DFS, HR: 0.660, 95% CI: 0.142–3.070, P = 0.596).ConclusionsPatients with stage I mEOC treated with FSS did not necessarily show a poorer prognosis than those receiving radical surgery.

Research highlights
► The first report about fertility-sparing surgery (FSS) in stage I mucinous ovarian cancer.
► Patients treated with FSS have a favorable prognosis, equal to those receiving radical surgery.