Schlaerth Alan C, Chi Dennis S, Poynor Elizabeth A, Barakat Richard R, Brown Carol L
Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Int J Gynecol Cancer. 2009 Oct;19(7):1199-204. doi: 10.1111/IGC.0b013e31819d82c3.
To determine the long-term results of fertility-sparing surgery in the treatment of early-stage invasive epithelial ovarian cancer.
A retrospective review of 123 patients who underwent surgical staging for FIGO stage I epithelial ovarian cancer from November 1982 to July 2002. Demographics, stage, histopathology, adjuvant therapy, recurrence, and survival were compared for patients who had fertility-sparing surgery and for those having standard surgical staging.
Twenty patients, with a median age of 27 years, had preservation of the uterus and contralateral ovary at the time of surgical staging. Platinum-based chemotherapy was administered to 50% of these patients postoperatively. Three patients (15%) recurred in the retained ovary at 9, 20, and 22 months, and all died of their disease. One patient was diagnosed with primary endometrial cancer at 15 months and was salvaged with hysterectomy. At a median follow-up of 122 months, 17 (85%) of 20 patients treated with fertility-sparing surgery were alive without disease. Of the 103 patients treated with removal of the uterus and both ovaries, 72% received adjuvant platinum chemotherapy. Twenty (19%) of the patients in the standard surgery group have recurred, and 17 have died of disease. At a median follow-up of 113 months, 78 (76%) of 103 patients treated with standard surgery were alive without disease. Five-year survival data showed no significant difference in the recurrence-free survival of the fertility-sparing and standard surgery groups (84% vs 78%) or overall survival (84% vs 82%).
Fertility-sparing surgery is a reasonable alternative treatment for young women with stage I epithelial ovarian cancer desiring fertility preservation.
确定保留生育功能手术治疗早期浸润性上皮性卵巢癌的长期效果。
回顾性分析1982年11月至2002年7月间接受FIGO I期上皮性卵巢癌手术分期的123例患者。比较接受保留生育功能手术的患者与接受标准手术分期的患者的人口统计学资料、分期、组织病理学、辅助治疗、复发情况和生存率。
20例患者在手术分期时保留了子宫和对侧卵巢，中位年龄为27岁。其中50%的患者术后接受了铂类化疗。3例患者（15%）分别在术后9、20和22个月时在保留的卵巢中复发，均死于该疾病。1例患者在术后15个月被诊断为原发性子宫内膜癌，行子宫切除术后得以挽救。中位随访122个月时，20例接受保留生育功能手术的患者中有17例（85%）无病存活。103例接受子宫和双侧卵巢切除的患者中，72%接受了辅助铂类化疗。标准手术组中有20例患者（19%）复发，17例死于该疾病。中位随访113个月时，103例接受标准手术的患者中有78例（76%）无病存活。五年生存数据显示，保留生育功能手术组和标准手术组的无复发生存率（84%对78%）或总生存率（84%对82%）无显著差异。
对于希望保留生育功能的I期上皮性卵巢癌年轻女性，保留生育功能手术是一种合理的替代治疗方法。
