Park Jin-Young, Heo Eun Jin, Lee Jeong-Won, Lee Yoo-Young, Kim Tae-Joong, Kim Byoung-Gie, Bae Duk-Soo
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Gynecol Oncol. 2016 Mar;27(2):e20. doi: 10.3802/jgo.2016.27.e20.
Fertility-sparing surgery (FSS) is becoming an important technique in the surgical management of young women with early-stage epithelial ovarian cancer (EOC). We retrospectively evaluated the outcome of laparoscopic FSS in presumed clinically early-stage EOC.
We retrospectively searched databases of patients who received laparoscopic FSS for EOC between January 1999 and December 2012 at Samsung Medical Center. Women aged ≤40 years were included. The perioperative, oncological, and obstetric outcomes of these patients were evaluated.
A total of 18 patients was evaluated. The median age of the patients was 33.5 years (range, 14 to 40 years). The number of patients with clinically stage IA and IC was 6 (33.3%) and 12 (66.7%), respectively. There were 7 (38.9%), 5 (27.8%), 3 (16.7%), and 3 patients (16.7%) with mucinous, endometrioid, clear cell, and serous tumor types, respectively. Complete surgical staging to preserve the uterus and one ovary with adnexa was performed in 4 patients (22.2%). Two out of them were upstaged to The International Federation of Gynecology and Obstetrics stage IIIA1. During the median follow-up of 47.3 months (range, 11.5 to 195.3 months), there were no perioperative or long term surgical complications. Four women (22.2%) conceived after their respective ovarian cancer treatments. Three (16.7%) of them completed full-term delivery and one is expecting a baby. One patient had disease recurrence. No patient died of the disease.
FSS in young patients with presumed clinically early-stage EOC is a challenging and cautious procedure. Further studies are urgent to determine the safety and feasibility of laparoscopic FSS in young patients with presumed clinically early-stage EOC.
保留生育功能手术（FSS）正成为早期上皮性卵巢癌（EOC）年轻女性手术治疗中的一项重要技术。我们回顾性评估了腹腔镜下FSS治疗临床疑似早期EOC的结果。
我们回顾性检索了1999年1月至2012年12月在三星医疗中心接受腹腔镜下FSS治疗EOC的患者数据库。纳入年龄≤40岁的女性。评估这些患者的围手术期、肿瘤学和产科结局。
共评估了18例患者。患者的中位年龄为33.5岁（范围14至40岁）。临床分期为IA期和IC期的患者分别有6例（33.3%）和12例（66.7%）。黏液性、子宫内膜样、透明细胞和浆液性肿瘤类型的患者分别有7例（38.9%）、5例（27.8%）、3例（16.7%）和3例（16.7%）。4例患者（22.2%）进行了完整的手术分期以保留子宫和一侧卵巢及其附件。其中2例患者被上调至国际妇产科联盟III A1期。在中位随访47.3个月（范围11.5至195.3个月）期间，无围手术期或长期手术并发症。4名女性（22.2%）在各自的卵巢癌治疗后受孕。其中3名（16.7%）完成了足月分娩，1名正在待产。1例患者疾病复发。无患者死于该疾病。
对临床疑似早期EOC的年轻患者进行FSS是一项具有挑战性且需谨慎操作的手术。迫切需要进一步研究以确定腹腔镜下FSS在临床疑似早期EOC年轻患者中的安全性和可行性。
