Elsevier

Fertility and Sterility

Volume 91, Issue 6, June 2009, Pages 2632-2637
Fertility and Sterility

Reproductive surgery
Laparoscopic fertility-sparing staging in unexpected early stage ovarian malignancies

https://doi.org/10.1016/j.fertnstert.2008.03.058Get rights and content
Under an Elsevier user license
open archive

Objective

To assess feasibility and safety of fertility-sparing laparoscopic staging in women affected by unexpected ovarian cancer desiring to preserve their fertility.

Design

Prospective study.

Setting

University clinic.

Patient(s)

Twenty-seven patients already operated on elsewhere for a presumably benign ovarian cyst.

Intervention(s)

Laparoscopic fertility-sparing staging operations.

Main Outcome Measure(s)

Perioperative and survival data, reproductive outcome.

Result(s)

Histologic findings after first surgery: 12 low malignant potential neoplasms, 11 invasive epithelial ovarian carcinomas,1 sex-cord stromal, and 3 germ cell neoplasms. Fertility-sparing staging consisted of exploration of the peritoneal cavity, peritoneal washing cytology, multiple peritoneal biopsies, omolateral adnexectomy (except in borderline tumors), omentectomy, omolateral or bilateral pelvic and aortic lymph node sampling (except in borderline tumors, well differentiated, mucinous, and granulosa cell (GC) neoplasms), endometrial biopsy, appendectomy in mucinous type. Overall, seven patients (26%) were upstaged. Six patients received adjuvant platinum-based chemotherapy. Two term pregnancies occurred. After a median follow-up of 20 months all patients are alive; one patient has FIGO stage Ic clear cell carcinoma, which recurred 8 months after surgery.

Conclusion(s)

Laparoscopic fertility-sparing staging in early ovarian malignancies is feasible and safe in selected and counseled patients and should be performed in experienced gynecological oncology centers trained in endoscopic procedures.

Key Words

Early stage ovarian cancer
laparoscopic staging
fertility-sparing surgery

Cited by (0)

L.M. has nothing to disclose. I.P. has nothing to disclose. M.S. has nothing to disclose. M.C. has nothing to disclose. F.P. has nothing to disclose. R.A. has nothing to disclose. P.B.P. has nothing to disclose.