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Ovarian Cancers pp 79–94Cite as

Oncofertility Applied to Epithelial Ovarian Cancer

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Abstract

Conservative treatment, consisting in uterine preservation with unilateral salpingo-oophorectomy, can be proposed to selected patients with early epithelial ovarian cancer, with a desire for pregnancy after a histological review and surgical staging.

This procedure can be safely proposed for common histological subtype (mucinous, serous and endometrioid), for stage IA grade 1 and 2, for stage IC1 grade 1 disease.

The literature review of oncological and fertility outcomes after fertility sparing surgery in patients with epithelial ovarian cancer shows: an overall recurrence rate of 12%, a median overall survival of 94% at 5 years, a rate of 43% patients willing a pregnancy of which 66% become pregnant.

Assisted conception procedures after conservative treatment are actually contraindicated, nevertheless many techniques for fertility preservation are now developed.

Follow-up is based on a clinical examination, an analysis of tumour markers and the use of systematic imaging, at least every 4 months for the first 2 years, then every 6 months until 5 years and every year thereafter. Test for BRCA1-2 mutations is indicated.

Completion surgery after childbearing, or after 40 years of age in patients who have not become pregnant, is recommended.

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References

  1. Prat J, FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014;124:1–5.

    Article  PubMed  Google Scholar 

  2. Morice P, Denschlag D, Rodolakis A, et al. Recommendations of the Fertility Task Force of the European Society of Gynecologic Oncology about the conservative management of ovarian malignant tumors. Int J Gynecol Cancer. 2011;21:951–63.

    Article  PubMed  Google Scholar 

  3. DiSaia PJ. Conservative management of the patient with early gynecologic cancer. CA Cancer J Clin. 1989;39:135–54.

    Article  CAS  PubMed  Google Scholar 

  4. Colombo N, Chiari S, Maggioni A, Bocciolone L, Torri V, Mangioni C. Controversial issues in the management of early epithelial ovarian cancer: conservative surgery and role of adjuvant therapy. Gynecol Oncol. 1994;55:S47–51.

    Article  CAS  PubMed  Google Scholar 

  5. Zanetta G, Chiari S, Rota S, et al. Conservative surgery for stage I ovarian carcinoma in women of childbearing age. Br J Obstet Gynaecol. 1997;104:1030–5.

    Article  CAS  PubMed  Google Scholar 

  6. Schilder JM, Thompson AM, DePriest PD, et al. Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy. Gynecol Oncol. 2002;87:1–7.

    Article  PubMed  Google Scholar 

  7. Morice P, Leblanc E, Rey A, et al. Conservative treatment in epithelial ovarian cancer: results of a multicentre study of the GCCLCC (Groupe des Chirurgiens de Centre de Lutte Contre le Cancer) and SFOG (Société Francaise d’Oncologie Gynécologique). Hum Reprod. 2005;20:1379–85.

    Article  CAS  PubMed  Google Scholar 

  8. Park JY, Kim DY, Suh DS, et al. Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer: oncologic safety and reproductive outcomes. Gynecol Oncol. 2008;110:345–53.

    Article  PubMed  Google Scholar 

  9. Anchezar JP, Sardi J, Soderini A. Long-term follow-up results of fertility sparing surgery in patients with epithelial ovarian cancer. J Surg Oncol. 2009;100:55–8.

    Article  PubMed  Google Scholar 

  10. Satoh T, Hatae M, Watanabe Y, et al. Outcomes of fertility-sparing surgery for stage I epithelial ovarian cancer: a proposal for patient selection. J Clin Oncol. 2010;28:1727–32.

    Article  PubMed  Google Scholar 

  11. Fruscio R, Corso S, Ceppi L, et al. Conservative management of early-stage epithelial ovarian cancer: results of a large retrospective series. Ann Oncol. 2013;24:138–44.

    Article  CAS  PubMed  Google Scholar 

  12. Shepherd JH. Revised FIGO staging for gynaecological cancer. Br J Obstet. 1989;96(8):889–92.

    Article  CAS  Google Scholar 

  13. Kajiyama H, Mizuno M, Shibata K, et al. Recurrence-predicting prognostic factors for patients with early-stage epithelial ovarian cancer undergoing fertility-sparing surgery: a multi-institutional study. Eur J Obstet Gynecol Reprod Biol. 2014;175:97–102.

    Article  PubMed  Google Scholar 

  14. Kashima K, Yahata T, Fujita K, Tanaka K. Outcomes of fertility-sparing surgery for women of reproductive age with FIGO stage IC epithelial ovarian cancer. Int J Gynaecol Obstet. 2013;121(1):53–5.

    Article  PubMed  Google Scholar 

  15. Wright JD, Shah M, Mathew L, et al. Fertility preservation in young women with epithelial ovarian cancer. Cancer. 2009;115(18):4118–26.

    Article  PubMed  Google Scholar 

  16. Ditto A, Martinelli F, Bogani G, et al. Long-term safety of fertility sparing surgery in early stage ovarian cancer: Comparison to standard radical surgical procedures. Gynecol Oncol. 2015;138(1):78–82.

    Article  PubMed  Google Scholar 

  17. Petrillo M, Legge F, Ferrandina G, et al. Fertility-sparing surgery in ovarian cancer extended beyond the ovaries: a case report and review of the literature. Gynecol Obstet Invest. 2014;77:1–5.

    Article  CAS  PubMed  Google Scholar 

  18. Lee JY, Jo YR, Kim TH, et al. Safety of fertility-sparing surgery in primary mucinous carcinoma of the ovary. Cancer Res Treat. 2015;47(2):290–7.

    Article  PubMed  Google Scholar 

  19. Kajiyama H, Shibata K, Suzuki S, et al. Is there any possibility of fertility-sparing surgery in patients with clear-cell carcinoma of the ovary? Gynecol Oncol. 2008;111:523–6.

    Article  PubMed  Google Scholar 

  20. Raspagliesi F, Fontanelli R, Paladini D, di Re EM. Conservative surgery in high-risk epithelial ovarian carcinoma. J Am Coll Surg. 1997;185(5):457–60.

    Article  CAS  PubMed  Google Scholar 

  21. Borgfeldt C, Iosif C, Måsbäck A. Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer. Eur J Obstet Gynecol Reprod Biol. 2007;134(1):110–4.

    Article  PubMed  Google Scholar 

  22. Schlaerth AC, Chi DS, Poynor EA, Barakat RR, Brown CL. Long-term survival after fertility-sparing surgery for epithelial ovarian cancer. Int J Gynecol Cancer. 2009;19(7):1199–204.

    Article  PubMed  Google Scholar 

  23. Kwon YS, Hahn HS, Kim TJ, et al. Fertility preservation in patients with early epithelial ovarian cancer. J Gynecol Oncol. 2009;20(1):44–7.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kajiyama H, Shibata K, Suzuki S, et al. Fertility-sparing surgery in young women with invasive epithelial ovarian cancer. Eur J Surg Oncol. 2010;36(4):404–8.

    Article  CAS  PubMed  Google Scholar 

  25. Cheng X, Cheng B, Wan X, Lu W, Xie X. Outcomes of conservative surgery in early epithelial ovarian carcinoma. Eur J Gynaecol Oncol. 2012;33(1):93–5.

    Article  CAS  PubMed  Google Scholar 

  26. Marpeau O, Schilder J, Zafrani Y, et al. Prognosis of patients who relapse after fertility-sparing surgery in epithelial ovarian cancer. Ann Surg Oncol. 2008;15:478–83.

    Article  PubMed  Google Scholar 

  27. Du Bois A, Heitz F, Harter P. Fertility-sparing surgery in ovarian cancer: a systematic review. Onkologie. 2013;36(7–8):436–43.

    PubMed  Google Scholar 

  28. Zapardiel I, Diestro MD, Aletti G. Conservative treatment of early stage ovarian cancer: oncological and fertility outcomes. Eur J Surg Oncol. 2014;40:387–93.

    Article  CAS  PubMed  Google Scholar 

  29. Morice P, Joulie F, Camatte S, et al. Lymph node involvement in epithelial ovarian cancer: analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg. 2003;197:198–205.

    Article  PubMed  Google Scholar 

  30. Cho YH, Kim DY, Kim JH, et al. Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors? Gynecol Oncol. 2006;103:878–82.

    Article  PubMed  Google Scholar 

  31. Schmeler KM, Tao X, Frumovitz M, et al. Prevalence of lymph node metastasis in primary mucinous carcinoma of the ovary. Obstet Gynecol. 2010;116(2 Pt 1):269–73.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Munnell EW. Is conservative therapy ever justified in stage I (IA) cancer of the ovary ? Am J Obstet Gynecol. 1969;103:641–50.

    Article  CAS  PubMed  Google Scholar 

  33. Benjamin I, Morgan MA, Rubin SC. Occult bilateral involvement in stage I epithelial ovarian cancer. Gynecol Oncol. 1999;72:288–91.

    Article  CAS  PubMed  Google Scholar 

  34. Leblanc E, Querleu D, Narducci F, Occelli B, Papageorgiou T, Sonoda Y. Laparoscopic staging of early stage invasive adnexal tumors: a 10-year experience. Gynecol Oncol. 2004;94:624–9.

    Article  CAS  PubMed  Google Scholar 

  35. Nezhat FR, Ezzati M, Chuang L, Shamshirsaz AA, Rahaman J, Gretz H. Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome. Am J Obstet Gynecol. 2009;200:83.

    Article  PubMed  Google Scholar 

  36. Ghezzi F, Malzoni M, Vizza E, et al. Laparoscopic staging of early ovarian cancer: results of a multi-institutional cohort study. Ann Surg Oncol. 2012;19:1589–94.

    Article  PubMed  Google Scholar 

  37. Tozzi R, Köhler C, Ferrara A, Schneider A. Laparoscopic treatment of early ovarian cancer: surgical and survival outcomes. Gynecol Oncol. 2004;93:199–203.

    Article  PubMed  Google Scholar 

  38. Schreuder HW, Pattij TO, Zweemer RP, van Baal MW, Verheijen RH. Increasing experience in laparoscopic staging of early ovarian cancer. Gynecol Surg. 2012;9:89–96.

    Article  PubMed  Google Scholar 

  39. Montanari G, Di Donato N, Del Forno S, et al. Laparoscopic management of early stage ovarian cancer: is it feasible, safe, and adequate? A retrospective study. Eur J Gynaecol Oncol. 2013;34(5):415–8.

    CAS  PubMed  Google Scholar 

  40. Finger TN, Nezhat FR. Robotic-assisted fertility-sparing surgery for early ovarian cancer. JSLS. 2014;18(2):308–13.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Donnez J, Silber S, Andersen CY, et al. Children born after autotransplantation of cryopreserved ovarian tissue. A review of 13 live births. Ann Med. 2011;243:437–50.

    Article  Google Scholar 

  42. Noyes N, Labella PA, Grifo J, Knopman JM. Oocyte cryopreservation: a feasible fertility preservation option for reproductive age cancer survivors. J Assist Reprod Genet. 2010;27:495–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Huang JYJ, Chian RC, Gilbert L, et al. Retrieval of immature oocytes from unstimulated ovaries followed by in vitro maturation and vitrification: a novel strategy of fertility preservation for breast cancer patients. AJS. 2010;200:177–83.

    Article  Google Scholar 

  44. Berwanger AL, Finet A, El Hachem H, le Parco S, Hesters L, Grynberg M. New trends in female fertility preservation: in vitro maturation of oocytes. Future Oncol. 2012;8(12):1567–73.

    Article  CAS  PubMed  Google Scholar 

  45. Bandera CA, Cramer DW, Friedman AJ, Sheets EE. Fertility therapy in the setting of a history of invasive epithelial ovarian cancer. Gynecol Oncol. 1995;58(1):116–9.

    Article  CAS  PubMed  Google Scholar 

  46. Grynberg M, Poulain M, Sebag-Peyrelevade S, le Parco S, Fanchin R, Frydman N. Ovarian tissue and follicle transplantation as an option for fertility preservation. Fertil Steril. 2012;97(6):1260–8.

    Article  PubMed  Google Scholar 

  47. Fortin A, Hazout A, Thoury A, Alvès K, Bats AS, Dhainaut C, Madelenat P. Assisted reproductive technologies after conservative management of borderline or invasive ovarian tumours. Gynecol Obstet Fertil. 2005;33(7–8):488–97.

    Article  CAS  PubMed  Google Scholar 

  48. Fadini R, Dal Canto M, Mignini Renzini M, et al. Embryo transfer following in vitro maturation and cryopreservation of oocytes recovered from antral follicles during conservative surgery for ovarian cancer. J Assist Reprod Genet. 2012;29(8):779–81.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Dittrich R, Hackl J, Lotz L, Hoffmann I, Beckmann MW. Pregnancies and live births after 20 transplantations of cryopreserved ovarian tissue in a single center. Fertil Steril. 2015;103(2):462–8.

    Article  PubMed  Google Scholar 

  50. Moore MM, Tewari K, Rose GS, Fruehauf JP, DiSaia PJ. Long-term consequences following conservative management of epithelial ovarian cancer in an infertile patient. Gynecol Oncol. 1999;73(3):452–4.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Service de Chirurgie Gynécologique, Gustave-Roussy Cancer Campus, 114 rue Edouard-Vaillant, Villejuif Cedex, 94805, France

    Enrica Bentivegna

  2. Gustave Roussy Cancer Campus, Villejuif, France

    Sebastien Gouy & Philippe Morice

  3. Hôpital de la Pitié-Salpétrière, Paris, France

    Catherine Uzan

  4. Hôpital Tenon, Paris, France

    Marcos Ballester & Emile Daraï

  5. Hôpital de Poissy, Poissy, France

    Catherine Poirot

Authors
  1. Enrica Bentivegna
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  2. Sebastien Gouy
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  3. Catherine Uzan
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  4. Marcos Ballester
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  5. Catherine Poirot
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  6. Emile Daraï
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  7. Philippe Morice
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Corresponding author

Correspondence to Enrica Bentivegna .

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Editors and Affiliations

  1. AP-HP, Hôtel-Dieu, Paris, France

    Eric Pujade-Lauraine

  2. Centre Léon Bérard, Université Claude Bernard, Lyon, France

    Isabelle Ray-Coquard

  3. Chirurgie cancérologique, HEGP, Paris, France

    Fabrice Lécuru

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Bentivegna, E. et al. (2017). Oncofertility Applied to Epithelial Ovarian Cancer. In: Pujade-Lauraine, E., Ray-Coquard, I., Lécuru, F. (eds) Ovarian Cancers. Springer, Cham. https://doi.org/10.1007/978-3-319-32110-3_7

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  • DOI: https://doi.org/10.1007/978-3-319-32110-3_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32108-0

  • Online ISBN: 978-3-319-32110-3

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