Fabio Ghezzi1, Antonella Cromi2, Francesco Fanfani3, Mario Malzoni4, Antonino Ditto5, Pierandrea De Iaco6, Stefano Uccella2, Valerio Gallotta7, Francesco Raspagliesi5, Giovanni Scambia7. 1. Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy. Electronic address: fabio.ghezzi@uninsubria.it. 2. Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy. 3. Gynecologic Oncology Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti, Pescara, Italy. 4. Advanced Gynecological Endoscopy Center, Malzoni Medical Center, Avellino, Italy. 5. Department of Gynecologic Oncology, IRCCS Foundation, National Cancer Institute, Milan, Italy. 6. Minimally Invasive Gynaecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy. 7. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Abstract
OBJECTIVE: There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to investigate the safety, adequacy and fertility outcome of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging using a multi-institutional sample. METHODS: Prospectively collected data in five gynecologic oncology service databases were searched for epithelial EOC patients undergoing laparoscopic fertility-preserving surgery. Surgical, pathologic, oncologic and reproductive outcome data were analysed. RESULTS: The study cohort consisted of 65 women. Median age of the patients was 33 (range: 21-42) years. In this cohort 36 (55.4%) and 29 (44.6%) patients were at low risk (FIGO stage IA G1-2) and high-risk (FIGO stage IA G3 or more), respectively. The disease was reclassified to a higher stage in 4 (6.1%) women. After a median follow up period of 38months (range: 2-144), the overall survival was 95.4% and recurrence-free survival 84.6%. Overall, there were 23 pregnancies in 22 women. After ovarian cancer treatment, 64.8% women reported pregnancy intent and 60% of these conceived spontaneously. CONCLUSIONS: Laparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.
OBJECTIVE: There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to investigate the safety, adequacy and fertility outcome of ovarian cancerpatients who underwent fertility-saving laparoscopic surgical staging using a multi-institutional sample. METHODS: Prospectively collected data in five gynecologic oncology service databases were searched for epithelial EOC patients undergoing laparoscopic fertility-preserving surgery. Surgical, pathologic, oncologic and reproductive outcome data were analysed. RESULTS: The study cohort consisted of 65 women. Median age of the patients was 33 (range: 21-42) years. In this cohort 36 (55.4%) and 29 (44.6%) patients were at low risk (FIGO stage IA G1-2) and high-risk (FIGO stage IA G3 or more), respectively. The disease was reclassified to a higher stage in 4 (6.1%) women. After a median follow up period of 38months (range: 2-144), the overall survival was 95.4% and recurrence-free survival 84.6%. Overall, there were 23 pregnancies in 22 women. After ovarian cancer treatment, 64.8% women reported pregnancy intent and 60% of these conceived spontaneously. CONCLUSIONS: Laparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.
Authors: Federica Tomao; Anna Di Pinto; Carolina Maria Sassu; Erlisa Bardhi; Violante Di Donato; Ludovico Muzii; Maria Cristina Petrella; Fedro Alessandro Peccatori; Pierluigi Benedetti Panici Journal: Ecancermedicalscience Date: 2018-12-06