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早期卵巢癌的保守治疗:肿瘤学和生育结局。

Conservative treatment of early stage ovarian cancer: oncological and fertility outcomes.

机构信息

Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.

Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.

出版信息

Eur J Surg Oncol. 2014 Apr;40(4):387-93. doi: 10.1016/j.ejso.2013.11.028. Epub 2013 Dec 13.

Abstract

BACKGROUND

Ovarian cancer may appear in young women during their reproductive age. As a result of late childbearing nowadays, fertility preservation has become a major issue in young women with gynecological cancer. The aim of this review is to update the current knowledge on conservative treatment and fertility preservation of women affected of early stage epithelial ovarian cancer.

MATERIAL AND METHODS

A web-based search in Medline and CancerLit databases on conservative treatment for early stage ovarian cancer has been carried out. All relevant information has been collected and analyzed.

RESULTS

Less than 40% of ovarian cancers are diagnosed at early stages. Conservative treatment may be considered in young patients with a relapse rate that ranges from 9% to 29%, and a 5-year survival ranging from 83% to 100%. Recurrences in the controlateral ovary has been reported to be less than 5%, with most of these patients being alive after savage treatments. Moreover, it has been reported good fertility outcomes after conservative treatment with a successful conception rate that ranges from 60% to 100%, with an abortion rate under 30% in all series reported.

CONCLUSIONS

Conservative treatment for early epithelial ovarian cancers could be a safe option for women younger than 40 years who wish to preserve their childbearing potential. We need a strict case selection such as FIGO stage I grade 1 and 2, although grade 3 cases could be considered.

摘要

背景

卵巢癌可能出现在年轻女性的生育年龄。由于当今晚育,生育力保存已成为妇科癌症年轻女性的主要问题。本综述的目的是更新早期上皮性卵巢癌保守治疗和生育力保存的最新知识。

材料和方法

在 Medline 和 CancerLit 数据库中进行了针对早期卵巢癌保守治疗的网络搜索。收集并分析了所有相关信息。

结果

不到 40%的卵巢癌在早期诊断。对于复发率为 9%至 29%、5 年生存率为 83%至 100%的年轻患者,可考虑采用保守治疗。对侧卵巢的复发率低于 5%,大多数接受过激进治疗的患者仍存活。此外,有报道称,在接受保守治疗后,生育力良好,受孕率为 60%至 100%,所有报道的流产率均低于 30%。

结论

对于希望保留生育能力的 40 岁以下的年轻女性,早期上皮性卵巢癌的保守治疗可能是一种安全的选择。我们需要严格的病例选择,如FIGO 分期 I 级和 2 级,尽管 3 级病例也可以考虑。

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