Fertility-sparing surgery in young women with invasive epithelial ovarian cancer

Objectives: The purpose of this study was to clarify the clinical outcome of patients with stage IA or more advanced epithelial ovarian cancer (EOC) treated with fertility-sparing surgery (FSS). Methods: After a central pathological review and search of the medical records from multiple institutions, a total of 60 stage I EOC patients treated with FSS were retrospectively evaluated in the current study. Results: The median age was 30 years (range: 12-40 years). The median follow-up time was 54.7 months (range: 4.8-243.8 months). The stage was IA in 30, IB in one, and IC in 29 patients. Fifty-two patients were alive without relapse and 8 patient experienced recurrences {IA, 2; IB, 1; IC(surface involvement), 1; and IC(positive cytology), 4}. However, all patients with stage IC(capsule rupture) (n = 17) were alive without recurrence. Collectively, there was no significant difference in the overall survival between the stage IA and IC groups (P = 0.256). Moreover, there was no significant difference in DFS and OS between patients with stage IC(capsule rupture) and those with stage IA. In contrast, DFS and OS of the patients with stage IC(surface involvement/positive cytology) were poorer than those of patients with stage IA {OS; P = 0.030, and DFS; P= 0.005, respectively}. Thirteen pregnancies were observed in 9 patients. Conclusions: FSS may be considered a treatment option in women with stage I EOC, even in those with stage IC(capsule rupture) or more wishing to bear children.