Introduction/Background To assess the safety of fertility sparing treatments for early-stage ovarian cancer in women younger than 45 years.
Methodology We performed a retrospective multicenter study including women from 18 to 45 years old diagnosed of early-stage (FIGO I-II) ovarian cancer in 55 Spanish hospitals, from January 2010 to December 2019. Benign and borderline tumors were excluded, as well as advanced-stage (FIGO III-IV). All perioperative characteristics and follow-up were collected and analyzed. Standard staging surgery (SSS) was compared to fertility sparing surgery (FSS) in terms of oncological outcomes.
Results A total of 630 women were included; 546 (86.7%) were stage I. The median tumor size was 94 mm (IQR 25–75: 60–139). The median patients´ age was 38.7 years old (IQR 25–75: 33.4–42.7) with a median body mass index of 23.6 kg/m2 (IQR 25–75: 21.2–27.7). Among all patients, 469 (74.4%) underwent SSS and 161 (25.6%) FSS. Up to 351 patients (56.3%) did not have children, but only 12 (1.92%) had oocyte preservation before treatment. Patients in the FSS group compared to SSS group showed a non- significant difference in recurrences (8.7% vs. 11.8%, respectively; p=0.31) and deaths (1.2% vs. 5.5%, respectively; p=0.087) during the follow-up. No significant differences were found between epithelial and non-epithelial ovarian cancer both in recurrences (9.1% vs. 8.3%, respectively; p=0–998) and deaths (4% vs. 3.6%, respectively; p=0.997) among patients who underwent FSS.
Conclusion FSS seems a safe option for treatment of early-stage ovarian cancer in patients who want to preserve fertility; either for epithelial and non-epithelial histology.
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