Ghezzi Fabio, Cromi Antonella, Fanfani Francesco, Malzoni Mario, Ditto Antonino, De Iaco Pierandrea, Uccella Stefano, Gallotta Valerio, Raspagliesi Francesco, Scambia Giovanni
Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy.
Department of Gynecology and Obstetrics, University of Insubria, Varese, Italy.
Gynecol Oncol. 2016 Jun;141(3):461-465. doi: 10.1016/j.ygyno.2016.03.030. Epub 2016 Apr 13.
There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to investigate the safety, adequacy and fertility outcome of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging using a multi-institutional sample.
Prospectively collected data in five gynecologic oncology service databases were searched for epithelial EOC patients undergoing laparoscopic fertility-preserving surgery. Surgical, pathologic, oncologic and reproductive outcome data were analysed.
The study cohort consisted of 65 women. Median age of the patients was 33 (range: 21-42) years. In this cohort 36 (55.4%) and 29 (44.6%) patients were at low risk (FIGO stage IA G1-2) and high-risk (FIGO stage IA G3 or more), respectively. The disease was reclassified to a higher stage in 4 (6.1%) women. After a median follow up period of 38months (range: 2-144), the overall survival was 95.4% and recurrence-free survival 84.6%. Overall, there were 23 pregnancies in 22 women. After ovarian cancer treatment, 64.8% women reported pregnancy intent and 60% of these conceived spontaneously.
Laparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.
关于早期卵巢癌（EOC）腹腔镜下保留生育功能手术的证据目前仍然有限。我们试图通过多机构样本研究接受保留生育功能腹腔镜手术分期的卵巢癌患者的安全性、充分性和生育结局。
在五个妇科肿瘤服务数据库中前瞻性收集的数据中，搜索接受腹腔镜保留生育功能手术的上皮性EOC患者。分析手术、病理、肿瘤学和生殖结局数据。
研究队列包括65名女性。患者的中位年龄为33岁（范围：21 - 42岁）。在该队列中，分别有36名（55.4%）和29名（44.6%）患者处于低风险（FIGO分期IA G1 - 2）和高风险（FIGO分期IA G3或更高）。4名（6.1%）女性的疾病被重新分类为更高分期。中位随访期38个月（范围：2 - 144个月）后，总生存率为95.4%，无复发生存率为84.6%。总体而言，22名女性中有23次妊娠。卵巢癌治疗后，64.8%的女性表示有妊娠意愿，其中60%自然受孕。
对于在早期卵巢癌情况下寻求保留生育功能的绝经前女性，腹腔镜分期可能是一种可行的选择。需要更多研究来确定腹腔镜检查是否能为这一特定人群带来生殖益处。
