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Pregnancy Outcomes After Conservative Surgical Management of Ovarian Neoplasms Treated at a Single Institution
  1. Gina M. Mantia Smaldone, MD,
  2. Scott D. Richard, MD and
  3. Robert P. Edwards, MD
  1. Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA.
  1. Address correspondence and reprint requests to Gina M. Mantia Smaldone, MD, Division of Gynecologic Oncology, Hospital of the University of Pennsylvania, 3rd Floor, PCAM, 34th and Spruce Streets, Philadelphia, PA 19104. E-mail: gina.mantia{at}hotmail.com.

Abstract

Hypothesis: Conservative surgical management of ovarian neoplasms can result in favorable oncologic and obstetric outcomes.

Methods: All reproductive-age women (18-45 years old) with stage IA to stage IIC ovarian neoplasms (N = 161) were retrospectively identified from a single institution's tumor registry between 1990 and 2007. Operative, pathological, outpatient, and delivery records were reviewed to confirm histological findings, stage, extent of surgical resection, adjuvant treatment, oncologic outcomes, and pregnancy outcomes.

Results: Women who underwent conservative surgical management for ovarian neoplasms (n = 61 [37.9%]) were identified, including those with low malignant potential (LMP, n = 36), epithelial (n = 12), germ cell (n = 6), and sex cord (n = 7) tumors. Thirteen women conceived 23 pregnancies, producing a pregnancy rate of 25.0% overall and of 68.4% for those attempting conception. Women with LMP tumors conceived most pregnancies and had the highest number of antenatal complications. Of those receiving adjuvant chemotherapy (n = 8), 12.5% were able to conceive after their treatment and with no reported congenital anomalies. Pregnancy after a diagnosis of ovarian neoplasm did not impact disease recurrence (0% vs 7.7%, P = 0.56) or survival (100% vs 100%, P = 1.0).

Conclusions: Conservative surgery may be an acceptable option for reproductive-age women with early-stage ovarian neoplasms. We report pregnancy and oncologic outcomes for a cohort of women managed conservatively for LMP, epithelial, germ cell, and sex cord ovarian neoplasms.

  • Fertility sparing
  • Conservative surgery
  • Ovarian cancer
  • Pregnancy

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Footnotes

  • The authors declare that there are no conflicts of interest.

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