Outcome of fertility preserving surgery in early stage ovarian cancer

AimTo assess the role of fertility preserving surgery in treatment of patients with stage IA, G1 or G2 ovarian carcinoma without adjuvant chemotherapy.Patients and methodsFrom 2006 to 2008, a prospective non-randomized study recruited 150 women, with suspicious early malignant ovarian mass.ResultsAmong the 150 explored patients, only 43 (28.6%) patients underwent exploration. Only 32/150 (21.3%) patients had proven stage IA, either G1 or G2, epithelial ovarian cancer. Among the 32 patients, 22 (68.7%) patients were nullipara while 10 (32.1%) had one child. All patients had unilateral tumors; 26 (81.25%) patients had G1 and 6 (18.75%) patients had G2 tumors; 24/32 (75.0%) tumors were serous, 6/32 (18.7%) were mucinous and 2/32 (6.2%) were endometrioid, and none was clear cell type. The median follow up period was 58.5 months (ranged: 48–72 months). Two patients (6.7%) were lost during follow up; data will be presented for the remaining 30 patients. One patient, at 27th month of follow up, had open abdominal exploration to investigate abnormal pelvic mass on routine ultrasound follow up examination. Frozen section revealed recurrent invasive mucinous tumor. She underwent radical surgery with pelvic and para-aortic lymph node dissection, followed by adjuvant chemotherapy, and remained free of disease, for the remaining 29 months of the follow up period. Neither distant metastases nor mortality were reported among our patients.ConclusionFertility preserving surgery can be considered a safe treatment strategy in patients with stage IA, G1 or G2 ovarian carcinoma.