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Published on: January 22, 2022
Fertility-Sparing Surgery for Non-Epithelial Ovarian Malignancies: Ten-Year Retrospective Study of Oncological and
Ivana Likic Ladjevic1,2, Jelena Dotlic1,2, Katarina Stefanovic1,2
1Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Dr Koste Todorovica 26, 11000 Belgrade, Serbia.
Background/Objectives:
Due to the rarity and histological heterogeneity of non-epithelial ovarian cancers (NEOCs), monitoring their reproductive and oncological outcomes is challenging. Therefore, this study aimed to investigate the oncological and reproductive outcomes of patients with NEOCs treated with fertility-sparing surgery over the past 10 years at our tertiary referral university clinic.
Methods:
This retrospective study included all the NEOC patients diagnosed and treated with fertility-sparing surgery from 2010 to 2019. The patient demographic and clinical characteristics; data regarding the treatment andthe clinical, laboratory, and imaging findings during follow-up; and disease recurrences were recorded. In this study, the recurrence-free survival and the overall survival were the oncological outcomes. The reproductive outcomes were assessed as attempting and achieving pregnancy.
Results:
This study included 39 patients. The most frequent NEOCs were granulosa cell tumors (53.8%). The majority of the tumors were in the IA or IC1 stage. The initial therapy was generally a unilateral salpingo-oophorectomy (30.8%). Adjuvant chemotherapy was received by 48.7% of the patients. An NEOC recurrence was registered in 25.6% of the patients, mostly during the first two postoperative years. The recurrence-free survival was 76.92%. A regression analysis showed that amore advanced stage of NEOC was the most important predictor of disease recurrence. The overall survival rate was 87.2%, with a mean time to an adverse outcome of 23.01 +/-10.68 months. The regression analysis showed that better survival depended mostly on not having disease recurrence. After treatment, ten patients tried to conceive and seven succeeded. All the children were in good condition upon birth.
Conclusions:
Fertility-sparing treatment for NEOCs was proven as a safe and successful option in terms of both oncological and reproductive outcomes.
Insights
Fertility-sparing surgery for non-epithelial ovarian cancers (NEOCs) is safe and effective. This approach offers successful oncologic and reproductive outcomes for patients, enabling them to achieve pregnancy post-treatment.
Area of Science:
- Gynecology
- Gynecologic Oncology
- Reproductive Medicine
Background:
- Non-epithelial ovarian cancers (NEOCs) are rare and histologically diverse, posing challenges in monitoring outcomes.
- Fertility-sparing surgery (FSS) is an option for NEOC patients desiring future fertility.
Purpose of the Study:
- To evaluate the oncologic and reproductive outcomes of patients with NEOCs treated with FSS.
- To analyze recurrence-free survival, overall survival, and pregnancy rates in this cohort.
Main Methods:
- Retrospective analysis of 39 NEOC patients treated with FSS between 2010 and 2019.
- Data collected included demographics, treatment details, follow-up findings, and recurrence status.
- Oncologic outcomes assessed by recurrence-free and overall survival; reproductive outcomes by pregnancy attempts and success.
Main Results:
- Granulosa cell tumors were the most common NEOC subtype (53.8%), predominantly at early stages (IA/IC1).
- Recurrence-free survival was 76.92%, with advanced stage predicting recurrence. Overall survival was 87.2%.
- Ten patients attempted pregnancy, with seven achieving successful conception and delivery of healthy infants.
Conclusions:
- Fertility-sparing treatment for NEOCs demonstrates favorable oncologic safety and efficacy.
- Successful reproductive outcomes, including pregnancy, are achievable following FSS for NEOCs.
