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484 Surgical management of premenopausal women with ovarian cancer
  1. C Martin-Gromaz,
  2. I Pelayo,
  3. V Corraliza-Galan,
  4. E Cabezas-Lopez,
  5. C Del Valle-Rubido,
  6. MJ Pablos-Antona,
  7. D Rubio-Marin,
  8. L Abarca-Martínez,
  9. E Moratalla-Bartolome,
  10. C Sanchez-Martinez and
  11. J Lazaro de la Fuente
  1. Ramon y Cajal Hospital , Obstetrics and Gynecology, Madrid, Spain


Introduction/Background*Ovarian cancer (OC) is the most lethal gynaecological malignancy worldwide The standard management of ovarian cancer in premenopausal women is not clear, and much controversy remains as to whether within this group of patients some of them with advanced stages should have primary cytoreductive surgery followed by chemotherapy or neoadjuvant chemotherapy followed by interval cytoreductive surgery. There is increasing evidence that the patients gain the most benefit from surgery are those with no residual disease at the completion of surgery (R0 resection).

Methodology Retrospective analysis of women under 45 years old diagnosed of epithelial and non-epithelial ovarian cancer during the last 10 years.

Result(s)*25 women under 45 years with OC were reviewed. Mean age at diagnosis was 36.27 years (SD 5.77; min:21, max: 43). Most of the tumors (52% N:13) were epithelial serous OC (Clear cells: 20.0% N:5; Endometrioid: 12.0 N:3; Mucinous: 8.0% N:2; Endodermal sinus: 4.0% N:1; Granulosa cell: 4.0% N: 1). Most of the patients were diagnosed in advanced tumoral stages (III-IV: 68.0%, N:17). Only 7 patients received neadyuvant quemotherapy (28%) previous to surgery. Surgical cytoreduction was made by laparotomy in most cases (84.0% N:21) preferred to laparoscopy (N:4, 16.0%). Complete surgical cytoreduction was achieved in 82.0% of cases (N:19). Surgical approach included: bilateral oophorectomy (96.0%, N:24), hysterectomy (82.0% N:19), omentectomy (96% N:24), appendicectomy (60.0% N:15), peritoneal biopsy (92.0% N: 23), peritonectomy (60.0% N:15), liver resection (40.0% N:10), intestinal resection (32.0% N:8), splenectomy (N:4), colecistectomy (N:2). Pelvic and paraaortic linfadenectomy was performed in 56.0% of cases (N: 14). Mean time of hospitalization was 7.84 days (4.16 SD; max:15, min:1). Few patients had complications: surgical urologic complications: 12.0% N:3; postsurgery complications: urological (N:2), abdominal wall infection (N:2), eventration (N:1), vascular (N:1).

Conclusion*Ovarian cancer in premenopausal women is a threatening condition, diagnosed in most cases in advanced stages, that needs a combination of quemotherapy and surgery. Surgical approach must be aggressive in order to achieve a complete resection of the tumor.

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