Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Hum Reprod. 2011 Dec;26(12):3297-302. doi: 10.1093/humrep/der342. Epub 2011 Oct 20.
Clear-cell carcinoma of the ovary (CCC) is often diagnosed at childbearing age, or sometimes during treatment for infertility. Therefore, most young women with early-stage CCC wish to preserve their reproductive and endocrine functions if possible.
Clinicopathologic data collected under the central pathological review system were subjected to survival analyses. We analyzed patients with stage I CCC who underwent fertility-sparing surgery (FSS, n = 16) and compared their long-term survival with those receiving radical surgery (n = 205), or patients with non-CCC undergoing FSS (n = 64).
There was no difference in both the overall survival (OS) and disease-free survival (DFS) between patients with CCC who underwent FSS and those who received radical surgery [CCC/FSS (n = 16) versus CCC/radical (n = 205); OS: P= 0.519, DFS: P= 0.265]. Moreover, patients with CCC who underwent FSS did not show a poorer OS and DFS than non-CCC patients who underwent FSS (CCC/FSS versus non-CCC/FSS; OS: P= 0.584, DFS: P= 0.401), or those at the corresponding stage with no CCC. Furthermore, according to the series of patients with CCC in both the current study and four studies in the literature, there was no difference in the recurrence rate between patients with or without CCC who were treated conservatively (CCC/FSS: 13.2% versus non-CCC/FSS: 10.9%, P= 0.614).
Although our study did not have sufficient power to yield a definite conclusion, our data suggests that at least patients with stage IA CCC may be treated with FSS.
卵巢透明细胞癌（CCC）常发生于育龄期，或在不孕症治疗过程中。因此，大多数早期 CCC 年轻女性希望尽可能保留其生殖和内分泌功能。
通过中心病理审查系统收集临床病理数据，进行生存分析。我们分析了接受保留生育功能手术（FSS）的 I 期 CCC 患者（n=16），并将其与接受根治性手术（n=205）或接受 FSS 的非 CCC 患者（n=64）的长期生存情况进行比较。
FSS 组和根治性手术组患者的总生存（OS）和无病生存（DFS）无差异[CCC/FSS（n=16）与 CCC/根治性手术（n=205）；OS：P=0.519，DFS：P=0.265]。此外，FSS 组 CCC 患者的 OS 和 DFS 并不比 FSS 组非 CCC 患者差（CCC/FSS 与非 CCC/FSS；OS：P=0.584，DFS：P=0.401），或与同期无 CCC 患者无差异。此外，根据本研究和文献中四项研究的 CCC 患者系列，保守治疗的 CCC 患者与非 CCC 患者的复发率无差异（CCC/FSS：13.2%与非 CCC/FSS：10.9%，P=0.614）。
尽管我们的研究没有足够的效力得出明确的结论，但我们的数据表明，至少 I 期 A 期 CCC 患者可以接受 FSS 治疗。
