Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Gynecologic Oncology, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
Curr Med Sci. 2020 Aug;40(4):745-752. doi: 10.1007/s11596-020-2239-4. Epub 2020 Aug 29.
With delayed childbearing in women, preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma (EOC). Fertility-sparing surgery (FSS) can be considered in patients with early-stage disease in order to preserve fertility and improve quality of life. In order to evaluate oncological safety, attitudes toward childbearing and reproductive outcomes in women with EOC who underwent FSS, this multicenter retrospective study was conducted. Between January 2005 and December 2014, total of 87 young women with FIGO stage I EOC were included, with their clinicopathologic parameters in relation to disease-free survival (DFS) and overall survival (OS) assessed. Attitudes toward childbearing, ovarian function and fertility were studied in women undergoing FSS (n=36). As a result, in contrast to radical surgery, FSS did not affect prognosis by Kaplan-Meier curves (log-rank test; DFS: P=0.484; OS: P=0.125). However, two of the three recurrence cases and both death cases were in FSS group stage IC. All women undergoing FSS resumed regular menstrual periods after chemotherapy. Only 16 (44.44%) had tried to conceive, and 17 pregnancies occurred in 15 (93.75%) women. Among 20 women who did not attempt conception, the most common reason was not being married (70%), followed by already having children (15%). In summary, FSS is considered safe in young women with stage IA EOC. Regular menstruation and good obstetric outcomes can be achieved. This study also provides some insight into the attitudes and social factors regarding fertility in EOC patients.
随着女性生育年龄的推迟，保留生育能力是生殖年龄上皮性卵巢癌（EOC）患者的一个重要问题。为了保留生育能力和提高生活质量，可以考虑在早期疾病患者中进行保留生育功能的手术（FSS）。为了评估接受 FSS 的 EOC 患者的肿瘤安全性、生育态度和生殖结局，进行了这项多中心回顾性研究。2005 年 1 月至 2014 年 12 月，共纳入 87 例 FIGO Ⅰ期 EOC 的年轻女性，评估其与无病生存（DFS）和总生存（OS）相关的临床病理参数。对接受 FSS 的女性（n=36）进行生育态度、卵巢功能和生育能力研究。结果，与根治性手术相比，FSS 并未通过 Kaplan-Meier 曲线影响预后（对数秩检验；DFS：P=0.484；OS：P=0.125）。然而，复发的 3 例中有 2 例和死亡的 2 例均在 FSS 组的 IC 期。所有接受 FSS 的女性在化疗后均恢复了正常月经周期。只有 16 名（44.44%）尝试过怀孕，15 名（93.75%）女性发生了 17 次妊娠。在 20 名未尝试怀孕的女性中，最常见的原因是未结婚（70%），其次是已经有孩子（15%）。总之，FSS 被认为是 IA 期 EOC 年轻女性安全的治疗方法。可以实现正常的月经和良好的产科结局。本研究还提供了一些关于 EOC 患者生育态度和社会因素的见解。
