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Safety of Fertility-Sparing Surgery for Premenopausal Women With Sex Cord-Stromal Tumors Confined to the Ovary
  1. Dimitrios Nasioudis, MD,
  2. Melissa K. Frey, MD,
  3. Eloise Chapman-Davis, MD,
  4. Steven S. Witkin, PhD and
  5. Kevin Holcomb, MD
  1. Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY.
  1. Address correspondence and reprint requests to Dimitrios Nasioudis, MD, Department of Obstetrics and Gynecology, Weill Cornell Medicine, 1300 York Ave, Box 35, New York, NY 10065. E-mail: din2004{at}med.cornell.edu.

Abstract

Objective The aim of this retrospective population-based study was to investigate the oncologic safety of fertility-sparing surgery (FSS) for premenopausal women with malignant sex cord-stromal tumors (SCSTs) confined to the ovary.

Methods A cohort of women aged 18 to 49 years and diagnosed with a stage I malignant SCST between 1984 and 2013 was drawn from the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Based on site-specific surgery codes, women who had FSS, defined as unilateral oophorectomy/tumor resection without hysterectomy, and definite surgery were identified. Cancer-specific survival and overall survival were evaluated after generation of Kaplan-Meier curves, whereas comparisons between the 2 groups were made with the log-rank test.

Results A total of 255 women who met the inclusion criteria were identified; 161 (63.1%) underwent FSS whereas 94 (36.9%) had definitive surgery (bilateral salpingo-oophorectomy and hysterectomy). Median follow-up was 104 months. Cancer-specific survival (P = 0.015) but not overall survival (P = 0.76) was superior for women who had definite surgery.

Conclusions In this retrospective population-based cohort of premenopausal women with SCSTs confined to the ovary, FSS was associated only with a worse long-term cancer-specific survival compared with definitive surgery. Women undergoing FSS for early stage SCSTs should be extensively counseled and closely monitored.

  • Ovarian cancer
  • Sex cord-stromal tumors
  • Granulosa cell
  • Fertility-sparing surgery

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Footnotes

  • The authors declare no conflicts of interest.