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Isr Med Assoc J. 2013 Feb;15(2):116-20.

Conservative fertility-sparing surgical treatment of invasive epithelial ovarian cancer: when is it acceptable?

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  • 1Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel. joseph12@internet-zahav.net

Abstract

The disadvantages of the reviewed studies dealing with fertility-sparing conservative surgery in EOC reported during the last 20 years are inherent in their retrospective nature. Many of the studies include a limited number of patients. The follow-up periods in these studies vary greatly and in some it is not indicated at all. Outcome is often given as the number of patients with recurrence or the number of patients alive at the end of follow-up and not as the probability of survival. The percentage of serous and mucinous carcinoma in stage I EOC in young patients is about equal. Yet, in many of the studies the rate of patients with mucinous carcinomas treated conservatively exceeds by far that of other histological types and is as high as 62-76%, while serous tumors comprise only a small proportion of the cases. In several studies the histological type is not given at all. An assessment of outcome according to histologic type of the tumor was not done in many of the studies, probably because of the limited number of patients. In some of the studies adjuvant chemotherapy was administered after conservative surgery. However, how this affected the outcome was not assessed. Nevertheless, it seems that the presented data indicate that fertility-sparing conservative surgery in stage IA grade 1 (and possibly grade 2) EOC does not significantly compromise survival and allows future fertility. Although favorable results have been reported in many studies that included conservatively treated patients with higher stage and grade, their number is too small to draw any conclusion.

PMID:
23516776
[PubMed - indexed for MEDLINE]
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