Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Eur J Surg Oncol. 2010 Apr;36(4):404-8. doi: 10.1016/j.ejso.2010.01.005. Epub 2010 Feb 8.
The purpose of this study was to clarify the clinical outcome of patients with stage IA or more advanced epithelial ovarian cancer (EOC) treated with fertility-sparing surgery (FSS).
After a central pathological review and search of the medical records from multiple institutions, a total of 60 stage I EOC patients treated with FSS were retrospectively evaluated in the current study.
The median age was 30 years (range: 12-40 years). The median follow-up time was 54.7 months (range: 4.8-243.8 months). The stage was IA in 30, IB in one, and IC in 29 patients. Fifty-two patients were alive without relapse and 8 patient experienced recurrences {IA, 2; IB, 1; IC(surface involvement), 1; and IC(positive cytology), 4}. However, all patients with stage IC(capsule rupture) (n=17) were alive without recurrence. Collectively, there was no significant difference in the overall survival between the stage IA and IC groups (P=0.256). Moreover, there was no significant difference in DFS and OS between patients with stage IC(capsule rupture) and those with stage IA. In contrast, DFS and OS of the patients with stage IC(surface involvement/positive cytology) were poorer than those of patients with stage IA {OS; P=0.030, and DFS; P=0.005, respectively}. Thirteen pregnancies were observed in 9 patients.
FSS may be considered a treatment option in women with stage I EOC, even in those with stage IC(capsule rupture) or more wishing to bear children.
本研究旨在阐明接受保留生育功能手术（FSS）治疗的 IA 期或更晚期上皮性卵巢癌（EOC）患者的临床结局。
在中央病理复查和多机构病历检索后，本研究回顾性评估了 60 例接受 FSS 治疗的 IA 期 EOC 患者。
中位年龄为 30 岁（范围：12-40 岁）。中位随访时间为 54.7 个月（范围：4.8-243.8 个月）。IA 期 30 例，IB 期 1 例，IC 期 29 例。52 例患者无复发且存活，8 例患者复发{IA 期 2 例，IB 期 1 例，IC（表面浸润）1 例，IC（细胞学阳性）4 例}。然而，所有 IA 期 IC（囊破裂）（n=17）患者均存活且无复发。总体而言，IA 期和 IC 期患者的总生存率无显著差异（P=0.256）。此外，IA 期 IC（囊破裂）和 IA 期患者的无病生存率（DFS）和总生存率（OS）无显著差异。相比之下，IA 期 IC（表面浸润/细胞学阳性）患者的 DFS 和 OS 较差{OS；P=0.030，DFS；P=0.005}。9 例患者中有 13 例观察到 13 例妊娠。
对于希望生育的 IA 期 EOC 患者，甚至是 IA 期 IC（囊破裂）或更晚期患者，FSS 可作为一种治疗选择。
