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Oncological and Reproductive Outcomes of Fertility-sparing Surgery in Women with Early-stage Epithelial Ovarian Carcinoma: A Multicenter Retrospective Study

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Summary

With delayed childbearing in women, preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma (EOC). Fertility-sparing surgery (FSS) can be considered in patients with early-stage disease in order to preserve fertility and improve quality of life. In order to evaluate oncological safety, attitudes toward childbearing and reproductive outcomes in women with EOC who underwent FSS, this multicenter retrospective study was conducted. Between January 2005 and December 2014, total of 87 young women with FIGO stage I EOC were included, with their clinicopathologic parameters in relation to disease-free survival (DFS) and overall survival (OS) assessed. Attitudes toward childbearing, ovarian function and fertility were studied in women undergoing FSS (n=36). As a result, in contrast to radical surgery, FSS did not affect prognosis by Kaplan-Meier curves (log-rank test; DFS: P=0.484; OS: P=0.125). However, two of the three recurrence cases and both death cases were in FSS group stage IC. All women undergoing FSS resumed regular menstrual periods after chemotherapy. Only 16 (44.44%) had tried to conceive, and 17 pregnancies occurred in 15 (93.75%) women. Among 20 women who did not attempt conception, the most common reason was not being married (70%), followed by already having children (15%). In summary, FSS is considered safe in young women with stage IA EOC. Regular menstruation and good obstetric outcomes can be achieved. This study also provides some insight into the attitudes and social factors regarding fertility in EOC patients.

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Author notes

  1. The authors contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Jing Chen, Yan Zhang, Bin Yang & Ke-zhen Li

  2. Department of Gynecologic Oncology, Women’s Hospital, Zhejiang University, Hangzhou, 310006, China

    Fen-fen Wang, Xin-yu Wang & Xiao-dong Cheng

  3. Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Ji-hui Ai

Authors
  1. Jing Chen
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  2. Fen-fen Wang
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  3. Yan Zhang
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  4. Bin Yang
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  5. Ji-hui Ai
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  6. Xin-yu Wang
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  7. Xiao-dong Cheng
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  8. Ke-zhen Li
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Corresponding authors

Correspondence to Xiao-dong Cheng or Ke-zhen Li.

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All authors declare that they have no conflict of interest.

Additional information

This work was supported by National Key Technology Research and Development Program of China (No. 2019YFC1005200, No. 2019YFC1005202 and No. 2018YFC1002103), National Natural Science Foundation of China (No. 81802896), and Hubei Province Health and Family Planning Scientific Research Project (No. WJ2019M127).

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Chen, J., Wang, Ff., Zhang, Y. et al. Oncological and Reproductive Outcomes of Fertility-sparing Surgery in Women with Early-stage Epithelial Ovarian Carcinoma: A Multicenter Retrospective Study. CURR MED SCI 40, 745–752 (2020). https://doi.org/10.1007/s11596-020-2239-4

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  • DOI: https://doi.org/10.1007/s11596-020-2239-4

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