演題抄録

International Symposium

開催概要
開催回
第53回・2015年・京都
 

Outcomes of Fertility-Sparing Surgery for Stage I Epithelial Ovarian Cancer: A Proposal for Patient Selection

演題番号 : IS2-4

[筆頭演者]
Satoh Toyomi:1 

1:Department of Obstetrics and Gynecology Faculty of Medicine, University of Tsukuba

 

Introduction: Fertility-sparing surgery (FSS) for stage I epithelial ovarian cancer (EOC) is an option available to young women. However, the recommended indications for such treatment remain controversial. The present study attempted to determine selection criteria for FSS in stage I EOC patients based on clinical outcomes for over 200 stage I EOC patients who underwent FSS.
Purpose: The objective of this study was to assess clinical outcomes and fertility in patients treated conservatively for unilateral, stage I invasive EOC.
Patients and Methods: A multi-institutional retrospective investigation was undertaken to identify patients with unilateral and stage I EOC treated using FSS. Favorable histology (FH) was defined as grade 1 or grade 2 adenocarcinoma, excluding clear cell histology (CCH).
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 in each group were: 100% and 97.8% for stage IA and FH (n=108); 100% and 100% for stage IA and CCH (n=15); 100% and 33.3% for stage IA and grade 3 (n=3); 96.9% and 92.1% for stage IC and FH (n=67); 93.3% and 66.0% in stage IC and CCH (n=15); and 66.7% and 66.7% for stage IC and grade 3 (n=3). Forty-five of 84 patients (53.6%) who were nulliparous at FSS and married at the time of investigation gave birth to 56 healthy children.
Conclusion: Our data confirm that FSS is a safe treatment for stage IA patients with FH and suggest that stage IA patients with CCH and stage IC patients with FH can be candidates for FSS followed by adjuvant chemotherapy.

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