A new policy regarding ovarian resection in young women treated for peritoneal carcinomatosis
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Updated: May 14, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Dominique Elias1, Emilie Duchalais, Peggy Dartigues
1Department of Surgery, Institut Gustave Roussy, Villejuif, France. elias@igr.fr
Objective:
To appreciate if the ovaries can be preserved in selected young women with peritoneal carcinomatosis (PC).
Background:
The traditional rule is to resect the ovaries systematically when PC is found at surgery.
Methods:
A new policy was developed to preserve the ovaries when they were macroscopically normal in young women with PC of different origin who expressed a strong desire for future pregnancy.
Results:
A total of 106 women younger than age 41 years underwent complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. At least one ovary was preserved in 29 % of them (and in 44 % of those who strongly wished future pregnancy). Among resected "normal" ovaries, 17 % were involved by tumor at the final pathologic examination. Among the resected "suspicious" ovaries, 38 % were involved. Among the 29 preserved ovaries (in 21 women), after a median follow-up of 32 months, 4 (14 %) developed ovarian recurrence, in 3 of them associated with other metastases. Two women became pregnant. In five women with partially normal ovary, egg harvesting and cryopreservation was performed.
Conclusions:
This new policy allowed ovarian preservation in 44 % of the young women wishing childbearing and allowed two births. Recurrence in the preserved ovary was 14 % with our criteria of selection. This policy is promising but can be further improved.
