Case ReportIs there any possibility of fertility-sparing surgery in patients with clear-cell carcinoma of the ovary?
Section snippets
Background
Epithelial ovarian carcinoma (EOC) is the leading cause of death from gynecological malignancy [1]. The standard surgical treatment of patients with EOC is based on hysterectomy and bilateral salpingo-oophorectomy with peritoneal sampling (peritoneal washing, omentectomy, multiple peritoneal biopsies, and the removal of peritoneal implants) with or without lymph-node sampling [2]. However, several reports have estimated that 3–17% of all EOCs occur in women under 40 years of age [3], [4], [5],
Cases
In the current study, FSS was carried out only when we could not obtain informed consent for our recommended surgical procedure from CCC patients who strongly desired to preserve fertility. As shown in Table 1, the mean age was 35.9 years (range: 32–39 years). The median follow-up time was 35.4 months (range: 21.7–153.2 months). All patients were nulliparous and received unilateral salpingo-oophorectomy. Two patients received laparoscopic cystectomy as an initial surgery prior to secondary
Conclusions
In general, patients with CCC have a poorer prognosis compared with those with other pathological types of EOC [14], [15]. Ordinary, standard surgery for stage I-CCC includes intact tumor removal, total abdominal hysterectomy and bilateral salpingo-oophorectomy, omentectomy, lymph-node sampling, peritoneal and diaphragmatic sampling, and multiple washing for cytology. Although CCC generally affects older women, it can also be observed in women of childbearing age, frequently associated with a
Conflict of interest statement
The authors declare that they have no conflicts of interest to disclose.
References (18)
- et al.
Ovarian clear cell adenocarcinoma
Gynecol Oncol
(1989) - et al.
Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease
Gynecol Oncol
(1996) - et al.
Thromboembolic complications in patients with clear cell carcinoma of the ovary
Gynecol Oncol
(2007) - et al.
Clear cell epithelial ovarian cancer (mesonephroid): bad prognosis only in early stages
Gynecol Oncol
(1993) - et al.
Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy
Gynecol Oncol
(2002) - et al.
Cancer statistics, 2001
CA Cancer J Clin
(2001) - et al.
Conservative treatment in epithelial ovarian cancer: results of a multicentre study of the GCCLCC (Groupe des Chirurgiens de Centre de Lutte Contre le Cancer) and SFOG (Societe Francaise d'Oncologie Gynecologique)
Hum Reprod
(2005) - et al.
Epithelial ovarian carcinoma in the reproductive age group
Cancer
(1999) - et al.
Profiles of women age 30–39 and age less than 30 with epithelial ovarian cancer
Obstet Gynecol
(1993)